- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,882.43 / $10,124.40 / $13,218.80
| Facility | | $4,882.43 | $10,124.40 | $13,218.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,245.65 / $24,758.05
| Facility | | $5,840.42 | $9,245.65 | $24,758.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,720.62 / $9,459.18 / $14,292.93
| Facility | | $5,720.62 | $9,459.18 | $14,292.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,433.00 / $13,433.00 / $13,433.00
| Facility | | $13,433.00 | $13,433.00 | $13,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,242.29 / $9,529.27 / $14,715.43
| Facility | | $8,242.29 | $9,529.27 | $14,715.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,245.65 / $24,758.05
| Facility | | $5,840.42 | $9,245.65 | $24,758.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,126.24 / $19,348.64
| Facility | | $5,840.42 | $9,126.24 | $19,348.64 |