- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,769.73 / $10,728.50 / $17,811.90
| Facility | | $6,769.73 | $10,728.50 | $17,811.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,068.10 / $30,068.10 / $30,068.10
| Facility | | $30,068.10 | $30,068.10 | $30,068.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,206.64 / $9,501.37 / $16,337.39
| Facility | | $6,206.64 | $9,501.37 | $16,337.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,247.67 / $11,727.45 / $20,482.11
| Facility | | $9,247.67 | $11,727.45 | $20,482.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,748.75 / $11,488.30 / $27,753.64
| Facility | | $5,748.75 | $11,488.30 | $27,753.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,748.75 / $10,968.62 / $15,415.85
| Facility | | $5,748.75 | $10,968.62 | $15,415.85 |