- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $10,232.93 / $15,488.17
| Facility | | $5,370.32 | $10,232.93 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,589.25 / $21,379.62
| Facility | | $4,466.84 | $12,589.25 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $7,413.10 / $11,748.98
| Facility | | $3,715.35 | $7,413.10 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $112.20
| Facility | | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $20,417.38
| Facility | | $6,606.93 | $10,715.19 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $31,622.78 / $31,622.78
| Facility | | $23,988.33 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $8,317.64 / $12,022.64
| Facility | | $5,128.61 | $8,317.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,549.93 / $22,908.68
| Facility | | $6,456.54 | $9,549.93 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,606.93 / $10,471.29
| Facility | | $2,511.89 | $6,606.93 | $10,471.29 |