- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,272.10 / $12,054.70 / $19,409.50
| Facility | | $5,272.10 | $12,054.70 | $19,409.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,542.46 / $17,542.43
| Facility | | $1,474.01 | $6,542.46 | $17,542.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,726.02 / $12,603.92 / $17,854.97
| Facility | | $8,726.02 | $12,603.92 | $17,854.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,627.50 / $10,571.26 / $22,200.95
| Facility | | $7,627.50 | $10,571.26 | $22,200.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,161.43 / $10,571.26 / $22,487.60
| Facility | | $7,161.43 | $10,571.26 | $22,487.60 |