- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $9,549.93 / $16,218.10
| Facility | | $4,677.35 | $9,549.93 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,709.64 / $23,442.29
| Facility | | $6,165.95 | $8,709.64 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,912.51 / $12,882.50
| Facility | | $5,888.44 | $8,912.51 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,709.64 / $23,442.29
| Facility | | $6,165.95 | $8,709.64 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,709.64 / $23,442.29
| Facility | | $6,165.95 | $8,709.64 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,413.10 / $20,417.38
| Facility | | $5,248.07 | $7,413.10 | $20,417.38 |