- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $5,623.41 / $15,488.17
| Facility | | $3,630.78 | $5,623.41 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $5,495.41 / $10,471.29
| Facility | | $4,365.16 | $5,495.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,090.30 / $4,786.30
| Facility | | $2,137.96 | $3,090.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $8,912.51 / $10,232.93
| Facility | | $5,370.32 | $8,912.51 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,387.21 / $22,387.21
| Facility | | $22,387.21 | $22,387.21 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,762.47 / $12,022.64
| Facility | | $2,951.21 | $7,762.47 | $12,022.64 |