- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,416.57 / $12,369.40 / $19,097.30
| Facility | | $8,416.57 | $12,369.40 | $19,097.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,428.45 / $17,428.45 / $17,428.45
| Facility | | $17,428.45 | $17,428.45 | $17,428.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,554.05 / $15,004.16 / $19,236.09
| Facility | | $10,554.05 | $15,004.16 | $19,236.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,472.54 / $18,314.29 / $23,164.27
| Facility | | $9,472.54 | $18,314.29 | $23,164.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,416.57 / $12,651.70 / $20,230.70
| Facility | | $8,416.57 | $12,651.70 | $20,230.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,843.08 / $16,831.80 / $25,572.39
| Facility | | $9,843.08 | $16,831.80 | $25,572.39 |