- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $9,332.54 / $25,118.86
| Facility | | $6,025.60 | $9,332.54 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $12,882.50 / $19,952.62
| Facility | | $8,912.51 | $12,882.50 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,589.25 / $16,982.44
| Facility | | $7,943.28 | $12,589.25 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $12,882.50 / $19,952.62
| Facility | | $2,951.21 | $12,882.50 | $19,952.62 |