- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $15,135.61 / $25,703.96
| Facility | | $7,413.10 | $15,135.61 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,125.38 / $37,153.52
| Facility | | $6,165.95 | $14,125.38 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $14,454.40 / $21,877.62
| Facility | | $8,709.64 | $14,454.40 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,803.84 / $37,153.52
| Facility | | $6,165.95 | $13,803.84 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,125.38 / $37,153.52
| Facility | | $6,165.95 | $14,125.38 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $11,220.18 / $32,359.37
| Facility | | $6,165.95 | $11,220.18 | $32,359.37 |