- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,772.37 / $26,915.35
| Facility | | $6,309.57 | $9,772.37 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,589.25 / $19,952.62
| Facility | | $8,709.64 | $12,589.25 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $13,182.57 / $17,782.79
| Facility | | $8,511.38 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $13,803.84 / $20,892.96
| Facility | | $2,951.21 | $13,803.84 | $20,892.96 |