- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,056.43 / $11,561.60 / $18,615.59
| Facility | | $5,056.43 | $11,561.60 | $18,615.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,940.13 / $10,434.04 / $17,690.25
| Facility | | $6,940.13 | $10,434.04 | $17,690.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $16,661.28
| Facility | | $1,474.01 | $6,242.69 | $16,661.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,793.79 / $11,450.04 / $17,124.59
| Facility | | $7,793.79 | $11,450.04 | $17,124.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,868.49 / $10,138.83 / $21,292.80
| Facility | | $6,868.49 | $10,138.83 | $21,292.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,868.49 / $10,138.83 / $18,279.12
| Facility | | $6,868.49 | $10,138.83 | $18,279.12 |