- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $4,897.79 / $6,456.54
| Facility | | $4,265.80 | $4,897.79 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $5,248.07 / $8,912.51
| Facility | | $2,187.76 | $5,248.07 | $8,912.51 |
- 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
- $4,570.88 / $6,025.60 / $8,709.64
| Facility | | $4,570.88 | $6,025.60 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,754.40 / $9,120.11
| Facility | | $3,801.89 | $5,754.40 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,495.41 / $8,511.38
| Facility | | $3,801.89 | $5,495.41 | $8,511.38 |