- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,022.64 / $14,454.40
| Facility | | $9,772.37 | $12,022.64 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,715.19 / $17,378.01
| Facility | | $10,471.29 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,022.64 / $19,054.61
| Facility | | $9,332.54 | $12,022.64 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $16,218.10 / $16,218.10
| Facility | | $7,762.47 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,489.63 / $20,417.38
| Facility | | $9,772.37 | $13,489.63 | $20,417.38 |