- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,942.46 / $9,417.51 / $15,635.30
| Facility | | $5,942.46 | $9,417.51 | $15,635.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,791.24 / $8,791.24 / $8,791.24
| Facility | | $8,791.24 | $8,791.24 | $8,791.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,640.50 / $8,449.79 / $14,314.15
| Facility | | $5,640.50 | $8,449.79 | $14,314.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,117.60 / $10,044.86 / $14,443.29
| Facility | | $8,117.60 | $10,044.86 | $14,443.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,046.25 / $10,084.43 / $25,222.10
| Facility | | $5,046.25 | $10,084.43 | $25,222.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,046.25 / $9,628.25 / $13,532.02
| Facility | | $5,046.25 | $9,628.25 | $13,532.02 |