- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,601.66 / $7,219.78 / $14,672.50
| Facility | | $5,601.66 | $7,219.78 | $14,672.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,485.77 / $8,485.77 / $8,485.77
| Facility | | $8,485.77 | $8,485.77 | $8,485.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,557.17 / $6,966.03 / $7,963.97
| Facility | | $5,557.17 | $6,966.03 | $7,963.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,471.32 / $7,914.71 / $10,293.43
| Facility | | $4,471.32 | $7,914.71 | $10,293.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,437.94 / $6,437.94 / $6,437.94
| Facility | | $6,437.94 | $6,437.94 | $6,437.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $8,211.76 / $11,132.19
| Facility | | $1,857.00 | $8,211.76 | $11,132.19 |