- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,674.79 / $9,693.84 / $12,656.70
| Facility | | $4,674.79 | $9,693.84 | $12,656.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $8,852.45 / $23,705.17
| Facility | | $5,840.42 | $8,852.45 | $23,705.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,477.34 / $9,056.91 / $13,685.09
| Facility | | $5,477.34 | $9,056.91 | $13,685.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,861.74 / $12,861.74 / $12,861.74
| Facility | | $12,861.74 | $12,861.74 | $12,861.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,891.78 / $9,124.02 / $14,089.62
| Facility | | $7,891.78 | $9,124.02 | $14,089.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $8,852.45 / $23,705.17
| Facility | | $5,840.42 | $8,852.45 | $23,705.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $8,738.12 / $18,525.80
| Facility | | $5,840.42 | $8,738.12 | $18,525.80 |