- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,895.93 / $13,481.10 / $21,706.20
| Facility | | $5,895.93 | $13,481.10 | $21,706.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,373.54 / $10,373.54 / $10,373.54
| Facility | | $10,373.54 | $10,373.54 | $10,373.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,362.99 / $20,474.65
| Facility | | $1,474.01 | $7,362.99 | $20,474.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,758.56 / $14,095.32 / $19,967.71
| Facility | | $9,758.56 | $14,095.32 | $19,967.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,008.83 / $11,534.06 / $24,416.56
| Facility | | $8,008.83 | $11,534.06 | $24,416.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,008.83 / $11,822.13 / $25,148.51
| Facility | | $8,008.83 | $11,822.13 | $25,148.51 |