- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $11,748.98 / $14,125.38
| Facility | | $9,772.37 | $11,748.98 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,715.19 / $16,982.44
| Facility | | $10,471.29 | $10,715.19 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,022.64 / $19,054.61
| Facility | | $9,332.54 | $12,022.64 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $16,595.87 / $16,595.87
| Facility | | $7,244.36 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,489.63 / $19,952.62
| Facility | | $9,772.37 | $13,489.63 | $19,952.62 |