- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $9,772.37 / $16,218.10
| Facility | | $4,677.35 | $9,772.37 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $23,988.33
| Facility | | $6,165.95 | $9,120.11 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $9,332.54 / $14,125.38
| Facility | | $5,495.41 | $9,332.54 | $14,125.38 |
- 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 / $8,912.51 / $23,988.33
| Facility | | $6,165.95 | $8,912.51 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $23,988.33
| Facility | | $6,165.95 | $9,120.11 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,413.10 / $20,892.96
| Facility | | $5,370.32 | $7,413.10 | $20,892.96 |