- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,742.12 / $12,805.60 / $20,433.30
| Facility | | $8,742.12 | $12,805.60 | $20,433.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,244.87 / $10,244.87 / $10,244.87
| Facility | | $10,244.87 | $10,244.87 | $10,244.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,542.68 / $11,708.98 / $17,444.72
| Facility | | $7,542.68 | $11,708.98 | $17,444.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,086.44 / $11,342.64 / $20,206.00
| Facility | | $8,086.44 | $11,342.64 | $20,206.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.95 / $120.00 / $188.69
| Facility | | $85.95 | $120.00 | $188.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,906.79 / $12,326.67 / $20,286.82
| Facility | | $8,906.79 | $12,326.67 | $20,286.82 |