- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $12,302.69 / $16,595.87
| Facility | | $6,456.54 | $12,302.69 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,709.64 / $14,454.40
| Facility | | $6,025.60 | $8,709.64 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $9,772.37 / $19,498.45
| Facility | | $4,677.35 | $9,772.37 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $9,549.93 / $18,620.87
| Facility | | $4,073.80 | $9,549.93 | $18,620.87 |