- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,959.03 / $11,465.30 / $16,105.70
| Facility | | $7,959.03 | $11,465.30 | $16,105.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,928.39 / $7,928.39 / $7,928.39
| Facility | | $7,928.39 | $7,928.39 | $7,928.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,737.76 / $10,665.60 / $15,890.24
| Facility | | $6,737.76 | $10,665.60 | $15,890.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,362.08 / $10,326.59 / $18,396.00
| Facility | | $7,362.08 | $10,326.59 | $18,396.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.25 / $113.68 / $182.53
| Facility | | $78.25 | $113.68 | $182.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,108.96 / $11,222.48 / $18,469.58
| Facility | | $8,108.96 | $11,222.48 | $18,469.58 |