- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,445.40 / $10,857.90 / $17,625.70
| Facility | | $7,445.40 | $10,857.90 | $17,625.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,484.33 / $14,484.33 / $16,915.05
| Facility | | $14,484.33 | $14,484.33 | $16,915.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,825.18 / $26,762.80 / $34,311.28
| Facility | | $18,825.18 | $26,762.80 | $34,311.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,742.65 / $16,903.09 / $21,379.35
| Facility | | $8,742.65 | $16,903.09 | $21,379.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,768.03 / $11,676.90 / $18,671.80
| Facility | | $7,768.03 | $11,676.90 | $18,671.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,223.78 / $15,534.83 / $23,601.92
| Facility | | $10,223.78 | $15,534.83 | $23,601.92 |