- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $7,943.28 / $10,232.93
| Facility | | $6,760.83 | $7,943.28 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $8,709.64 / $11,220.18
| Facility | | $6,309.57 | $8,709.64 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $8,317.64 / $14,454.40
| Facility | | $3,467.37 | $8,317.64 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $9,549.93 / $28,840.32
| Facility | | $7,244.36 | $9,549.93 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $9,549.93 / $41,686.94
| Facility | | $6,025.60 | $9,549.93 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $8,709.64 / $15,488.17
| Facility | | $5,754.40 | $8,709.64 | $15,488.17 |