- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.10 / $10,294.60 / $18,115.50
| Facility | | $6,098.10 | $10,294.60 | $18,115.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,713.29 / $5,531.61 / $8,988.82
| Facility | | $3,713.29 | $5,531.61 | $8,988.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,547.18 / $9,489.11 / $13,659.98
| Facility | | $5,547.18 | $9,489.11 | $13,659.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,069.40 / $19,069.40 / $22,379.56
| Facility | | $19,069.40 | $19,069.40 | $22,379.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $8,971.66 / $12,814.99
| Facility | | $1,787.00 | $8,971.66 | $12,814.99 |