- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,715.19 / $12,882.50
| Facility | | $8,912.51 | $10,715.19 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,772.37 / $15,488.17
| Facility | | $9,549.93 | $9,772.37 | $15,488.17 |
- 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
- $8,511.38 / $10,964.78 / $17,378.01
| Facility | | $8,511.38 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $14,125.38 / $14,125.38
| Facility | | $6,606.93 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $12,302.69 / $18,197.01
| Facility | | $8,912.51 | $12,302.69 | $18,197.01 |