- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,615.90 / $9,480.58 / $16,683.09
| Facility | | $5,615.90 | $9,480.58 | $16,683.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,498.54 / $9,750.04 / $15,906.70
| Facility | | $6,498.54 | $9,750.04 | $15,906.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,108.54 / $8,738.78 / $12,579.84
| Facility | | $5,108.54 | $8,738.78 | $12,579.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,082.85 / $16,082.85 / $18,874.59
| Facility | | $16,082.85 | $16,082.85 | $18,874.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,262.24 / $11,801.66
| Facility | | $1,787.00 | $8,262.24 | $11,801.66 |