- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,495.26 / $8,371.51 / $17,013.09
| Facility | | $6,495.26 | $8,371.51 | $17,013.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,201.16 / $6,201.16 / $6,201.16
| Facility | | $6,201.16 | $6,201.16 | $6,201.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,343.85 / $7,952.15 / $9,091.36
| Facility | | $6,343.85 | $7,952.15 | $9,091.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,184.60 / $9,177.29 / $11,935.48
| Facility | | $5,184.60 | $9,177.29 | $11,935.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $7,359.97 / $11,334.53
| Facility | | $1,286.00 | $7,359.97 | $11,334.53 |