- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,196.43 / $7,636.92 / $11,790.70
| Facility | | $5,196.43 | $7,636.92 | $11,790.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,537.51 / $11,537.51 / $11,712.46
| Facility | | $11,537.51 | $11,537.51 | $11,712.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,727.59 / $13,829.22 / $17,729.77
| Facility | | $9,727.59 | $13,829.22 | $17,729.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,848.39 / $11,307.32 / $14,301.72
| Facility | | $5,848.39 | $11,307.32 | $14,301.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,196.43 / $7,811.24 / $12,490.50
| Facility | | $5,196.43 | $7,811.24 | $12,490.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,077.16 / $10,392.02 / $15,788.50
| Facility | | $6,077.16 | $10,392.02 | $15,788.50 |