- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $15,135.61 / $25,118.86
| Facility | | $7,244.36 | $15,135.61 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,803.84 / $36,307.81
| Facility | | $6,165.95 | $13,803.84 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,125.38 / $20,417.38
| Facility | | $9,120.11 | $14,125.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $20,892.96 / $20,892.96
| Facility | | $20,892.96 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,489.63 / $36,307.81
| Facility | | $6,165.95 | $13,489.63 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,803.84 / $36,307.81
| Facility | | $6,165.95 | $13,803.84 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $10,964.78 / $31,622.78
| Facility | | $6,165.95 | $10,964.78 | $31,622.78 |