- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,228.51 / $9,668.50 / $15,567.50
| Facility | | $4,228.51 | $9,668.50 | $15,567.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,438.52 / $7,438.52 / $7,438.52
| Facility | | $7,438.52 | $7,438.52 | $7,438.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.55 / $5,855.07 / $13,239.12
| Facility | | $912.55 | $5,855.07 | $13,239.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,865.00 / $9,575.25 / $14,320.67
| Facility | | $6,865.00 | $9,575.25 | $14,320.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,117.68 / $8,478.73 / $17,806.39
| Facility | | $6,117.68 | $8,478.73 | $17,806.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,541.33 / $10,108.00 / $15,286.16
| Facility | | $6,541.33 | $10,108.00 | $15,286.16 |