- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,120.11 / $10,715.19
| Facility | | $5,888.44 | $9,120.11 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $9,772.37 / $13,489.63
| Facility | | $6,606.93 | $9,772.37 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,128.31 / $11,748.98
| Facility | | $5,370.32 | $8,128.31 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,000.00 / $19,952.62
| Facility | | $6,165.95 | $10,000.00 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $10,232.93 / $14,125.38
| Facility | | $4,073.80 | $10,232.93 | $14,125.38 |