- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $8,511.38 / $8,511.38
| Facility | | $8,511.38 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,748.98 / $20,417.38
| Facility | | $7,244.36 | $11,748.98 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $33,884.42 / $35,481.34
| Facility | | $25,703.96 | $33,884.42 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $8,511.38 / $19,498.45
| Facility | | $8,511.38 | $8,511.38 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $13,803.84 / $20,417.38
| Facility | | $9,332.54 | $13,803.84 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,589.25 / $13,489.63
| Facility | | $9,772.37 | $12,589.25 | $13,489.63 |