- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,941.32 / $11,718.10 / $20,620.50
| Facility | | $6,941.32 | $11,718.10 | $20,620.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,010.39 / $5,885.49 / $9,736.21
| Facility | | $4,010.39 | $5,885.49 | $9,736.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,314.22 / $10,801.23 / $15,548.83
| Facility | | $6,314.22 | $10,801.23 | $15,548.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,637.25 / $21,637.25 / $25,393.15
| Facility | | $21,637.25 | $21,637.25 | $25,393.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $10,444.00 / $16,993.00
| Facility | | $3,158.00 | $10,444.00 | $16,993.00 |