- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $8,912.51 / $10,964.78
| Facility | | $3,801.89 | $8,912.51 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,589.25 / $22,387.21
| Facility | | $5,128.61 | $12,589.25 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $7,943.28 / $7,943.28
| Facility | | $7,943.28 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $10,232.93 / $14,454.40
| Facility | | $8,317.64 | $10,232.93 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,244.36 / $13,489.63
| Facility | | $2,511.89 | $7,244.36 | $13,489.63 |