- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,202.73 / $9,114.15 / $9,114.15
| Facility | | $8,202.73 | $9,114.15 | $9,114.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,846.47 / $7,900.25 / $20,342.96
| Facility | | $5,846.47 | $7,900.25 | $20,342.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,390.80 / $3,851.58 / $8,258.34
| Facility | | $2,390.80 | $3,851.58 | $8,258.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,533.94 / $10,406.40 / $15,770.66
| Facility | | $7,533.94 | $10,406.40 | $15,770.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $13,616.32 / $17,580.93
| Facility | | $6,965.00 | $13,616.32 | $17,580.93 |