- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,813.06 / $7,492.24 / $15,226.20
| Facility | | $5,813.06 | $7,492.24 | $15,226.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,373.38 / $6,373.38 / $7,211.96
| Facility | | $6,373.38 | $6,373.38 | $7,211.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,680.71 / $7,120.89 / $8,141.02
| Facility | | $5,680.71 | $7,120.89 | $8,141.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,640.06 / $8,213.40 / $10,681.88
| Facility | | $4,640.06 | $8,213.40 | $10,681.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,329.39 / $7,329.39 / $8,293.75
| Facility | | $7,329.39 | $7,329.39 | $8,293.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,586.94 / $10,144.06
| Facility | | $1,286.00 | $6,586.94 | $10,144.06 |