- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,043.14 / $6,958.75 / $11,646.50
| Facility | | $5,043.14 | $6,958.75 | $11,646.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.82 / $12,022.82 / $14,469.63
| Facility | | $12,022.82 | $12,022.82 | $14,469.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $7,833.77 / $12,070.74
| Facility | | $2,423.00 | $7,833.77 | $12,070.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,161.62 / $7,828.89 / $13,129.00
| Facility | | $5,161.62 | $7,828.89 | $13,129.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $6,318.35 / $14,049.58
| Facility | | $2,600.00 | $6,318.35 | $14,049.58 |