- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,941.32 / $9,011.83 / $14,510.20
| Facility | | $3,941.32 | $9,011.83 | $14,510.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $4,685.33 / $12,735.14
| Facility | | $1,474.01 | $4,685.33 | $12,735.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,514.00 / $8,924.91 / $13,348.03
| Facility | | $6,514.00 | $8,924.91 | $13,348.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,702.17 / $7,902.87 / $16,597.00
| Facility | | $5,702.17 | $7,902.87 | $16,597.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,353.75 / $7,902.87 / $16,811.29
| Facility | | $5,353.75 | $7,902.87 | $16,811.29 |