- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,511.43 / $12,601.90 / $20,290.59
| Facility | | $5,511.43 | $12,601.90 | $20,290.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,577.45 / $9,577.45 / $9,577.45
| Facility | | $9,577.45 | $9,577.45 | $9,577.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,129.35 / $17,737.57
| Facility | | $1,474.01 | $7,129.35 | $17,737.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,122.15 / $13,176.09 / $18,665.50
| Facility | | $9,122.15 | $13,176.09 | $18,665.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,973.76 / $11,051.15 / $23,208.77
| Facility | | $7,973.76 | $11,051.15 | $23,208.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,486.53 / $11,051.15 / $23,508.44
| Facility | | $7,486.53 | $11,051.15 | $23,508.44 |