- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,141.72 / $9,470.06 / $15,248.00
| Facility | | $4,141.72 | $9,470.06 | $15,248.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,930.56 / $14,557.60
| Facility | | $1,474.01 | $5,930.56 | $14,557.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,855.10 / $9,378.71 / $14,026.74
| Facility | | $6,855.10 | $9,378.71 | $14,026.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,992.11 / $8,304.70 / $17,440.91
| Facility | | $5,992.11 | $8,304.70 | $17,440.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,625.97 / $8,904.65 / $17,666.11
| Facility | | $5,625.97 | $8,904.65 | $17,666.11 |