- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $10,715.19 / $17,782.79
| Facility | | $5,128.61 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,772.37 / $26,302.68
| Facility | | $6,165.95 | $9,772.37 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,232.93 / $15,488.17
| Facility | | $6,025.60 | $10,232.93 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,772.37 / $26,302.68
| Facility | | $6,165.95 | $9,772.37 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,772.37 / $26,302.68
| Facility | | $6,165.95 | $9,772.37 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,128.31 / $22,908.68
| Facility | | $5,888.44 | $8,128.31 | $22,908.68 |