- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.54 / $7,739.96 / $11,949.80
| Facility | | $5,266.54 | $7,739.96 | $11,949.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,892.06 / $9,892.06 / $9,892.06
| Facility | | $9,892.06 | $9,892.06 | $9,892.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,264.23 / $8,905.54 / $11,417.37
| Facility | | $6,264.23 | $8,905.54 | $11,417.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,114.78 / $6,102.36 / $13,246.27
| Facility | | $3,114.78 | $6,102.36 | $13,246.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.54 / $7,916.63 / $12,659.00
| Facility | | $5,266.54 | $7,916.63 | $12,659.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,159.16 / $10,532.23 / $16,001.53
| Facility | | $6,159.16 | $10,532.23 | $16,001.53 |