- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,479.69 / $9,250.62 / $16,278.40
| Facility | | $5,479.69 | $9,250.62 | $16,278.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,125.23 / $13,502.09 / $22,271.46
| Facility | | $9,125.23 | $13,502.09 | $22,271.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,984.63 / $8,526.81 / $12,274.70
| Facility | | $4,984.63 | $8,526.81 | $12,274.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,307.90 / $19,307.90 / $22,659.46
| Facility | | $19,307.90 | $19,307.90 | $22,659.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,061.83 / $11,515.40
| Facility | | $1,787.00 | $8,061.83 | $11,515.40 |