- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,028.76 / $7,770.25 / $15,791.20
| Facility | | $6,028.76 | $7,770.25 | $15,791.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,341.30 / $4,341.30 / $4,651.84
| Facility | | $4,341.30 | $4,341.30 | $4,651.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,023.32 / $8,803.87 / $10,065.11
| Facility | | $7,023.32 | $8,803.87 | $10,065.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,812.24 / $8,518.16 / $11,078.24
| Facility | | $4,812.24 | $8,518.16 | $11,078.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,992.50 / $4,992.50 / $5,349.62
| Facility | | $4,992.50 | $4,992.50 | $5,349.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,831.36 / $10,520.46
| Facility | | $1,286.00 | $6,831.36 | $10,520.46 |