- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $10,232.93 / $14,125.38
| Facility | | $5,495.41 | $10,232.93 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $8,511.38 / $8,511.38
| Facility | | $8,511.38 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,511.38 / $13,803.84
| Facility | | $5,623.41 | $8,511.38 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $10,964.78 / $15,135.61
| Facility | | $5,370.32 | $10,964.78 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,943.28 / $16,595.87
| Facility | | $3,981.07 | $7,943.28 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $8,128.31 / $15,848.93
| Facility | | $3,388.44 | $8,128.31 | $15,848.93 |