- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,446.20 / $12,452.80 / $20,050.50
| Facility | | $5,446.20 | $12,452.80 | $20,050.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,568.75 / $9,568.75 / $12,012.44
| Facility | | $9,568.75 | $9,568.75 | $12,012.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,146.70 / $17,790.16
| Facility | | $1,474.01 | $9,146.70 | $17,790.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,014.19 / $13,020.16 / $18,444.62
| Facility | | $9,014.19 | $13,020.16 | $18,444.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,879.39 / $13,323.53 / $22,934.11
| Facility | | $7,879.39 | $13,323.53 | $22,934.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,235.26 / $10,920.36 / $22,407.00
| Facility | | $7,235.26 | $10,920.36 | $22,407.00 |