- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,642.51 / $7,272.43 / $14,779.50
| Facility | | $5,642.51 | $7,272.43 | $14,779.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,663.20 / $7,663.20 / $8,328.94
| Facility | | $7,663.20 | $7,663.20 | $8,328.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,091.09 / $7,635.31 / $8,729.12
| Facility | | $6,091.09 | $7,635.31 | $8,729.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,503.93 / $7,972.43 / $10,368.48
| Facility | | $4,503.93 | $7,972.43 | $10,368.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,812.68 / $8,812.68 / $8,812.68
| Facility | | $8,812.68 | $8,812.68 | $8,812.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,393.69 / $9,846.44
| Facility | | $1,286.00 | $6,393.69 | $9,846.44 |