- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,721.83 / $13,083.00 / $21,065.20
| Facility | | $5,721.83 | $13,083.00 | $21,065.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,099.69 / $10,099.69 / $10,099.69
| Facility | | $10,099.69 | $10,099.69 | $10,099.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,818.83 / $17,485.83
| Facility | | $1,474.01 | $6,818.83 | $17,485.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,470.39 / $13,679.09 / $19,378.07
| Facility | | $9,470.39 | $13,679.09 | $19,378.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,278.16 / $11,473.03 / $24,094.77
| Facility | | $8,278.16 | $11,473.03 | $24,094.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,772.33 / $11,473.03 / $24,405.88
| Facility | | $7,772.33 | $11,473.03 | $24,405.88 |