- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,185.35 / $9,260.94 / $18,820.70
| Facility | | $7,185.35 | $9,260.94 | $18,820.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,120.76 / $7,120.76 / $7,120.76
| Facility | | $7,120.76 | $7,120.76 | $7,120.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,670.77 / $7,108.43 / $8,126.77
| Facility | | $5,670.77 | $7,108.43 | $8,126.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,735.44 / $10,152.34 / $13,203.55
| Facility | | $5,735.44 | $10,152.34 | $13,203.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $9,224.84 / $12,968.92
| Facility | | $1,518.00 | $9,224.84 | $12,968.92 |