- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,574.10 / $10,458.70 / $16,839.80
| Facility | | $4,574.10 | $10,458.70 | $16,839.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,119.50 / $12,119.50 / $12,119.50
| Facility | | $12,119.50 | $12,119.50 | $12,119.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,367.44 / $6,199.41 / $14,909.97
| Facility | | $1,367.44 | $6,199.41 | $14,909.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,570.74 / $10,935.22 / $15,491.05
| Facility | | $7,570.74 | $10,935.22 | $15,491.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,617.66 / $9,171.67 / $19,261.64
| Facility | | $6,617.66 | $9,171.67 | $19,261.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,213.29 / $9,171.67 / $19,510.34
| Facility | | $6,213.29 | $9,171.67 | $19,510.34 |