- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,047.04 / $9,253.57 / $14,899.40
| Facility | | $4,047.04 | $9,253.57 | $14,899.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $5,159.93 / $13,892.73
| Facility | | $1,474.01 | $5,159.93 | $13,892.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,698.40 / $9,470.00 / $13,706.09
| Facility | | $6,698.40 | $9,470.00 | $13,706.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,855.13 / $8,114.86 / $17,042.21
| Facility | | $5,855.13 | $8,114.86 | $17,042.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,497.36 / $8,114.86 / $17,262.25
| Facility | | $5,497.36 | $8,114.86 | $17,262.25 |