- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,404.71 / $9,970.39 / $16,553.20
| Facility | | $7,404.71 | $9,970.39 | $16,553.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,783.83 / $7,783.83 / $7,783.83
| Facility | | $7,783.83 | $7,783.83 | $7,783.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,048.06 / $9,060.36 / $15,348.44
| Facility | | $6,048.06 | $9,060.36 | $15,348.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,594.16 / $10,709.00 / $15,796.00
| Facility | | $8,594.16 | $10,709.00 | $15,796.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,342.50 / $10,676.45 / $27,044.56
| Facility | | $5,342.50 | $10,676.45 | $27,044.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,342.50 / $10,193.49 / $14,326.45
| Facility | | $5,342.50 | $10,193.49 | $14,326.45 |