- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,471.29 / $16,982.44
| Facility | | $7,413.10 | $10,471.29 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $7,413.10 / $12,589.25
| Facility | | $3,715.35 | $7,413.10 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $20,417.38
| Facility | | $6,606.93 | $10,964.78 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $26,302.68 / $26,302.68
| Facility | | $26,302.68 | $26,302.68 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $10,232.93 / $16,982.44
| Facility | | $3,981.07 | $10,232.93 | $16,982.44 |
- 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
- $3,715.35 / $8,912.51 / $19,952.62
| Facility | | $3,715.35 | $8,912.51 | $19,952.62 |