- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,064.47 / $10,501.90 / $13,711.70
| Facility | | $5,064.47 | $10,501.90 | $13,711.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,590.41 / $25,681.23
| Facility | | $5,840.42 | $9,590.41 | $25,681.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,933.93 / $9,811.89 / $14,825.88
| Facility | | $5,933.93 | $9,811.89 | $14,825.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,933.89 / $13,933.89 / $13,933.89
| Facility | | $13,933.89 | $13,933.89 | $13,933.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,549.64 / $9,884.60 / $15,264.14
| Facility | | $8,549.64 | $9,884.60 | $15,264.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,590.41 / $25,681.23
| Facility | | $5,840.42 | $9,590.41 | $25,681.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,466.54 / $20,070.11
| Facility | | $5,840.42 | $9,466.54 | $20,070.11 |