- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,407.17 / $10,628.40 / $14,262.50
| Facility | | $6,407.17 | $10,628.40 | $14,262.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,213.82 / $8,213.82 / $8,213.82
| Facility | | $8,213.82 | $8,213.82 | $8,213.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,651.21 / $10,071.40 / $15,836.72
| Facility | | $5,651.21 | $10,071.40 | $15,836.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,261.15 / $8,557.50 / $19,625.77
| Facility | | $5,261.15 | $8,557.50 | $19,625.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,246.40 / $8,429.70 / $11,941.71
| Facility | | $6,246.40 | $8,429.70 | $11,941.71 |