- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,197.39 / $9,234.54 / $14,783.10
| Facility | | $6,197.39 | $9,234.54 | $14,783.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,843.15 / $8,843.15 / $8,843.15
| Facility | | $8,843.15 | $8,843.15 | $8,843.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,071.94 / $7,921.27 / $11,241.19
| Facility | | $4,071.94 | $7,921.27 | $11,241.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,498.73 / $7,366.68 / $12,907.41
| Facility | | $5,498.73 | $7,366.68 | $12,907.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,399.31 / $8,342.84 / $11,179.66
| Facility | | $5,399.31 | $8,342.84 | $11,179.66 |