- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,756.50 / $9,952.89 / $16,524.20
| Facility | | $7,756.50 | $9,952.89 | $16,524.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,166.42 / $7,166.42 / $7,166.42
| Facility | | $7,166.42 | $7,166.42 | $7,166.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,745.30 / $8,360.02 / $14,129.67
| Facility | | $5,745.30 | $8,360.02 | $14,129.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,579.08 / $10,746.00 / $15,851.00
| Facility | | $8,579.08 | $10,746.00 | $15,851.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,333.13 / $10,657.72 / $24,419.72
| Facility | | $5,333.13 | $10,657.72 | $24,419.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,333.13 / $10,175.60 / $14,301.31
| Facility | | $5,333.13 | $10,175.60 | $14,301.31 |