- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,245.69 / $8,855.59 / $15,583.30
| Facility | | $5,245.69 | $8,855.59 | $15,583.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,751.47 / $7,030.50 / $11,630.39
| Facility | | $4,751.47 | $7,030.50 | $11,630.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,771.78 / $8,162.69 / $11,750.54
| Facility | | $4,771.78 | $8,162.69 | $11,750.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,531.65 / $15,531.65 / $18,227.71
| Facility | | $15,531.65 | $15,531.65 | $18,227.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $7,717.57 / $11,023.67
| Facility | | $1,787.00 | $7,717.57 | $11,023.67 |