- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,299.45 / $12,117.20 / $19,510.20
| Facility | | $5,299.45 | $12,117.20 | $19,510.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,218.89 / $15,218.89 / $15,218.89
| Facility | | $15,218.89 | $15,218.89 | $15,218.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $4,700.46 / $16,422.37
| Facility | | $1,474.01 | $4,700.46 | $16,422.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,771.29 / $12,669.31 / $17,947.61
| Facility | | $8,771.29 | $12,669.31 | $17,947.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,667.08 / $10,626.10 / $22,316.13
| Facility | | $7,667.08 | $10,626.10 | $22,316.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,198.59 / $10,626.10 / $22,604.27
| Facility | | $7,198.59 | $10,626.10 | $22,604.27 |