- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,748.98 / $15,488.17
| Facility | | $7,244.36 | $11,748.98 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,454.40 / $17,782.79
| Facility | | $9,772.37 | $14,454.40 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $13,803.84
| Facility | | $13,803.84 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,964.78 / $14,454.40
| Facility | | $7,413.10 | $10,964.78 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $13,803.84
| Facility | | $13,803.84 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,232.93 / $15,848.93
| Facility | | $6,456.54 | $10,232.93 | $15,848.93 |