- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,669.30 / $10,676.40 / $17,190.30
| Facility | | $4,669.30 | $10,676.40 | $17,190.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,981.42 / $9,981.42 / $9,981.42
| Facility | | $9,981.42 | $9,981.42 | $9,981.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,204.71 / $14,980.13
| Facility | | $1,474.01 | $6,204.71 | $14,980.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,728.32 / $11,162.83 / $15,813.49
| Facility | | $7,728.32 | $11,162.83 | $15,813.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,755.40 / $9,362.57 / $19,662.56
| Facility | | $6,755.40 | $9,362.57 | $19,662.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,342.62 / $9,362.57 / $19,916.43
| Facility | | $6,342.62 | $9,362.57 | $19,916.43 |