- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,148.74 / $10,676.60 / $13,939.90
| Facility | | $5,148.74 | $10,676.60 | $13,939.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,749.95 / $26,108.49
| Facility | | $5,840.42 | $9,749.95 | $26,108.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,032.66 / $9,975.12 / $15,072.54
| Facility | | $6,032.66 | $9,975.12 | $15,072.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,165.71 / $14,165.71 / $14,165.71
| Facility | | $14,165.71 | $14,165.71 | $14,165.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,691.87 / $10,049.04 / $15,518.09
| Facility | | $8,691.87 | $10,049.04 | $15,518.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,749.95 / $26,108.49
| Facility | | $5,840.42 | $9,749.95 | $26,108.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,624.03 / $20,404.02
| Facility | | $5,840.42 | $9,624.03 | $20,404.02 |