- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,923.29 / $13,543.60 / $21,806.90
| Facility | | $5,923.29 | $13,543.60 | $21,806.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,359.89 / $10,359.89 / $10,359.89
| Facility | | $10,359.89 | $10,359.89 | $10,359.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,870.67 / $19,210.47
| Facility | | $1,474.01 | $6,870.67 | $19,210.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,322.00 / $13,412.98 / $20,060.34
| Facility | | $9,322.00 | $13,412.98 | $20,060.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,569.62 / $11,876.98 / $24,943.12
| Facility | | $8,569.62 | $11,876.98 | $24,943.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,045.98 / $11,876.98 / $25,265.18
| Facility | | $8,045.98 | $11,876.98 | $25,265.18 |