- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,276.90 / $9,224.84 / $14,242.40
| Facility | | $6,276.90 | $9,224.84 | $14,242.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,947.98 / $10,947.98 / $10,947.98
| Facility | | $10,947.98 | $10,947.98 | $10,947.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,779.54 / $13,903.09 / $17,824.47
| Facility | | $9,779.54 | $13,903.09 | $17,824.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,872.86 / $7,552.22 / $15,787.51
| Facility | | $3,872.86 | $7,552.22 | $15,787.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,276.90 / $9,435.41 / $15,087.60
| Facility | | $6,276.90 | $9,435.41 | $15,087.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,340.77 / $12,552.80 / $19,071.34
| Facility | | $7,340.77 | $12,552.80 | $19,071.34 |