- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,671.10 / $10,572.30 / $17,552.40
| Facility | | $6,671.10 | $10,572.30 | $17,552.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,482.31 / $4,482.31 / $7,887.43
| Facility | | $4,482.31 | $4,482.31 | $7,887.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,010.51 / $9,004.09 / $15,253.13
| Facility | | $6,010.51 | $9,004.09 | $15,253.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,707.00 / $11,276.52 / $16,146.61
| Facility | | $8,707.00 | $11,276.52 | $16,146.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,665.00 / $11,320.94 / $26,876.62
| Facility | | $5,665.00 | $11,320.94 | $26,876.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,665.00 / $10,808.82 / $15,191.26
| Facility | | $5,665.00 | $10,808.82 | $15,191.26 |