- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,912.51 / $10,232.93
| Facility | | $6,918.31 | $8,912.51 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,165.95 / $10,964.78
| Facility | | $2,187.76 | $6,165.95 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $7,943.28 / $9,549.93
| Facility | | $6,760.83 | $7,943.28 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $7,079.46 / $12,589.25
| Facility | | $2,630.27 | $7,079.46 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $9,332.54 / $12,022.64
| Facility | | $1,513.56 | $9,332.54 | $12,022.64 |