- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,353.08 / $13,658.30 / $17,951.70
| Facility | | $9,353.08 | $13,658.30 | $17,951.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,112.54 / $10,112.54 / $10,112.54
| Facility | | $10,112.54 | $10,112.54 | $10,112.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,349.98 / $14,688.65 / $24,643.23
| Facility | | $5,349.98 | $14,688.65 | $24,643.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,501.45 / $13,718.98 / $22,962.48
| Facility | | $9,501.45 | $13,718.98 | $22,962.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,764.91 / $15,310.57 / $22,354.67
| Facility | | $11,764.91 | $15,310.57 | $22,354.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,764.91 / $14,233.21 / $22,354.67
| Facility | | $11,764.91 | $14,233.21 | $22,354.67 |