- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,000.26 / $13,143.10 / $17,274.50
| Facility | | $9,000.26 | $13,143.10 | $17,274.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,159.44 / $10,159.44 / $10,159.44
| Facility | | $10,159.44 | $10,159.44 | $10,159.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,963.49 / $13,517.45 / $22,862.94
| Facility | | $4,963.49 | $13,517.45 | $22,862.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,143.04 / $13,201.47 / $22,096.28
| Facility | | $9,143.04 | $13,201.47 | $22,096.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,321.11 / $14,733.01 / $21,511.40
| Facility | | $11,321.11 | $14,733.01 | $21,511.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,321.11 / $13,696.30 / $21,511.40
| Facility | | $11,321.11 | $13,696.30 | $21,511.40 |