- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,545.71 / $9,362.07 / $16,474.50
| Facility | | $5,545.71 | $9,362.07 | $16,474.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,989.01 / $5,938.35 / $9,764.04
| Facility | | $3,989.01 | $5,938.35 | $9,764.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,044.68 / $8,629.54 / $12,422.59
| Facility | | $5,044.68 | $8,629.54 | $12,422.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,960.00 / $16,960.00 / $19,904.00
| Facility | | $16,960.00 | $16,960.00 | $19,904.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,158.96 / $11,654.14
| Facility | | $1,787.00 | $8,158.96 | $11,654.14 |