- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,787.26 / $7,458.99 / $15,158.70
| Facility | | $5,787.26 | $7,458.99 | $15,158.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,588.41 / $7,005.19 / $8,008.74
| Facility | | $5,588.41 | $7,005.19 | $8,008.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,619.47 / $8,176.95 / $10,634.48
| Facility | | $4,619.47 | $8,176.95 | $10,634.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,295.14 / $7,295.14 / $7,295.14
| Facility | | $7,295.14 | $7,295.14 | $7,295.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,557.71 / $10,099.04
| Facility | | $1,286.00 | $6,557.71 | $10,099.04 |