- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.46 / $12,279.60 / $19,771.70
| Facility | | $5,370.46 | $12,279.60 | $19,771.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,364.57 / $9,364.57 / $9,364.57
| Facility | | $9,364.57 | $9,364.57 | $9,364.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,264.42 / $17,686.66
| Facility | | $1,474.01 | $7,264.42 | $17,686.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,888.83 / $12,839.08 / $18,188.09
| Facility | | $8,888.83 | $12,839.08 | $18,188.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,295.05 / $10,506.09 / $22,240.44
| Facility | | $7,295.05 | $10,506.09 | $22,240.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,295.05 / $10,768.49 / $22,907.16
| Facility | | $7,295.05 | $10,768.49 | $22,907.16 |