- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,429.88 / $10,854.70 / $19,101.09
| Facility | | $6,429.88 | $10,854.70 | $19,101.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,030.42 / $7,488.68 / $12,313.14
| Facility | | $5,030.42 | $7,488.68 | $12,313.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,848.98 / $10,005.37 / $14,403.17
| Facility | | $5,848.98 | $10,005.37 | $14,403.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,654.85 / $22,654.85 / $26,587.39
| Facility | | $22,654.85 | $22,654.85 | $26,587.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,459.77 / $13,512.20
| Facility | | $1,787.00 | $9,459.77 | $13,512.20 |