- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,302.69 / $19,952.62
| Facility | | $8,709.64 | $12,302.69 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $10,232.93 / $10,232.93
| Facility | | $10,232.93 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $9,120.11 / $15,488.17
| Facility | | $4,570.88 | $9,120.11 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,882.50 / $23,988.33
| Facility | | $7,762.47 | $12,882.50 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $30,902.95 / $30,902.95
| Facility | | $30,902.95 | $30,902.95 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $12,022.64 / $19,952.62
| Facility | | $4,677.35 | $12,022.64 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,220.18 / $25,703.96
| Facility | | $7,585.78 | $11,220.18 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $10,471.29 / $23,442.29
| Facility | | $4,073.80 | $10,471.29 | $23,442.29 |