- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,358.46 / $9,297.37 / $15,435.80
| Facility | | $6,358.46 | $9,297.37 | $15,435.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,062.00 / $3,062.00 / $3,062.00
| Facility | | $3,062.00 | $3,062.00 | $3,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,568.86 / $8,525.04 / $14,132.35
| Facility | | $5,568.86 | $8,525.04 | $14,132.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,014.04 / $9,916.71 / $14,259.03
| Facility | | $8,014.04 | $9,916.71 | $14,259.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,981.88 / $9,955.78 / $24,901.77
| Facility | | $4,981.88 | $9,955.78 | $24,901.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,981.88 / $9,505.42 / $13,359.40
| Facility | | $4,981.88 | $9,505.42 | $13,359.40 |