- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,646.49 / $7,844.05 / $13,803.30
| Facility | | $4,646.49 | $7,844.05 | $13,803.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,170.29 / $4,170.29 / $4,170.29
| Facility | | $4,170.29 | $4,170.29 | $4,170.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,805.09 / $6,947.17 / $11,422.78
| Facility | | $4,805.09 | $6,947.17 | $11,422.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,226.71 / $7,230.30 / $10,408.32
| Facility | | $4,226.71 | $7,230.30 | $10,408.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,025.50 / $15,025.50 / $17,633.70
| Facility | | $15,025.50 | $15,025.50 | $17,633.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $6,836.02 / $9,764.46
| Facility | | $1,787.00 | $6,836.02 | $9,764.46 |