- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,551.42 / $9,438.00 / $12,322.60
| Facility | | $4,551.42 | $9,438.00 | $12,322.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $8,618.83 / $23,079.54
| Facility | | $5,840.42 | $8,618.83 | $23,079.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,332.78 / $8,817.87 / $13,323.92
| Facility | | $5,332.78 | $8,817.87 | $13,323.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,522.29 / $12,522.29 / $12,522.29
| Facility | | $12,522.29 | $12,522.29 | $12,522.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,683.50 / $8,883.21 / $13,717.77
| Facility | | $7,683.50 | $8,883.21 | $13,717.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $8,618.83 / $23,079.54
| Facility | | $5,840.42 | $8,618.83 | $23,079.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $8,507.51 / $18,036.87
| Facility | | $5,840.42 | $8,507.51 | $18,036.87 |