- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,499.94 / $9,666.40 / $19,644.70
| Facility | | $7,499.94 | $9,666.40 | $19,644.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,629.56 / $7,629.56 / $7,629.56
| Facility | | $7,629.56 | $7,629.56 | $7,629.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,131.95 / $8,940.04 / $10,220.79
| Facility | | $7,131.95 | $8,940.04 | $10,220.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,986.55 / $10,596.83 / $13,781.63
| Facility | | $5,986.55 | $10,596.83 | $13,781.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,537.62 / $8,537.62 / $8,537.62
| Facility | | $8,537.62 | $8,537.62 | $8,537.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $10,628.22 / $14,904.63
| Facility | | $1,518.00 | $10,628.22 | $14,904.63 |