- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $13,182.57 / $15,848.93
| Facility | | $10,964.78 | $13,182.57 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $12,022.64 / $19,054.61
| Facility | | $11,748.98 | $12,022.64 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $13,489.63 / $21,379.62
| Facility | | $10,471.29 | $13,489.63 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $17,378.01 / $17,378.01
| Facility | | $8,317.64 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,135.61 / $22,387.21
| Facility | | $10,964.78 | $15,135.61 | $22,387.21 |