- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $14,125.38 / $23,442.29
| Facility | | $6,760.83 | $14,125.38 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,589.25 / $34,673.69
| Facility | | $6,165.95 | $12,589.25 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $13,489.63 / $19,952.62
| Facility | | $7,943.28 | $13,489.63 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $19,498.45 / $19,498.45
| Facility | | $19,498.45 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,589.25 / $34,673.69
| Facility | | $6,165.95 | $12,589.25 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,589.25 / $34,673.69
| Facility | | $6,165.95 | $12,589.25 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,471.29 / $30,199.52
| Facility | | $6,165.95 | $10,471.29 | $30,199.52 |