- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $12,882.50 / $13,182.57
| Facility | | $10,715.19 | $12,882.50 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $13,803.84 / $19,952.62
| Facility | | $7,943.28 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,220.18 / $19,952.62
| Facility | | $8,317.64 | $11,220.18 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $10,715.19 / $13,803.84
| Facility | | $9,332.54 | $10,715.19 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,589.25 / $20,892.96
| Facility | | $7,943.28 | $12,589.25 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $8,128.31 / $10,715.19
| Facility | | $91.20 | $8,128.31 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $14,791.08 / $15,135.61
| Facility | | $11,748.98 | $14,791.08 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $13,489.63 / $18,620.87
| Facility | | $7,943.28 | $13,489.63 | $18,620.87 |