- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $12,589.25 / $15,135.61
| Facility | | $10,232.93 | $12,589.25 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $18,197.01
| Facility | | $15,488.17 | $15,488.17 | $18,197.01 |
- 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
- $9,772.37 / $12,882.50 / $19,952.62
| Facility | | $9,772.37 | $12,882.50 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $14,791.08 / $14,791.08
| Facility | | $7,244.36 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,125.38 / $21,379.62
| Facility | | $10,232.93 | $14,125.38 | $21,379.62 |