- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $12,589.25 / $15,135.61
| Facility | | $10,232.93 | $12,589.25 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $11,220.18 / $17,782.79
| Facility | | $10,964.78 | $11,220.18 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,589.25 / $19,952.62
| Facility | | $9,772.37 | $12,589.25 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $16,982.44 / $16,982.44
| Facility | | $8,128.31 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,125.38 / $21,379.62
| Facility | | $10,232.93 | $14,125.38 | $21,379.62 |