- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,964.78 / $17,782.79
| Facility | | $7,762.47 | $10,964.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,943.28 / $13,489.63
| Facility | | $4,073.80 | $7,943.28 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $11,481.54 / $21,379.62
| Facility | | $6,760.83 | $11,481.54 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $26,915.35 / $26,915.35
| Facility | | $26,915.35 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $10,715.19 / $17,782.79
| Facility | | $4,168.69 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,772.37 / $22,908.68
| Facility | | $6,760.83 | $9,772.37 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $9,120.11 / $20,892.96
| Facility | | $3,801.89 | $9,120.11 | $20,892.96 |