- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,191.37 / $8,763.89 / $15,421.90
| Facility | | $5,191.37 | $8,763.89 | $15,421.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,655.64 / $8,362.42 / $14,816.40
| Facility | | $4,655.64 | $8,362.42 | $14,816.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,544.81 / $5,324.11 / $8,592.85
| Facility | | $3,544.81 | $5,324.11 | $8,592.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,722.35 / $8,078.17 / $11,628.86
| Facility | | $4,722.35 | $8,078.17 | $11,628.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,604.90 / $16,604.90 / $19,487.25
| Facility | | $16,604.90 | $16,604.90 | $19,487.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $7,637.65 / $10,909.51
| Facility | | $1,787.00 | $7,637.65 | $10,909.51 |