- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $11,220.18 / $16,218.10
| Facility | | $7,079.46 | $11,220.18 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $11,220.18 / $16,595.87
| Facility | | $6,918.31 | $11,220.18 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,471.29 / $19,054.61
| Facility | | $7,585.78 | $10,471.29 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $128.82 / $204.17
| Facility | | $85.11 | $128.82 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $9,120.11 / $15,848.93
| Facility | | $4,265.80 | $9,120.11 | $15,848.93 |