- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $12,882.50 / $24,547.09
| Facility | | $9,549.93 | $12,882.50 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,882.50 / $16,595.87
| Facility | | $8,317.64 | $12,882.50 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,803.84 / $26,302.68
| Facility | | $9,120.11 | $13,803.84 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $13,182.57 / $17,378.01
| Facility | | $8,317.64 | $13,182.57 | $17,378.01 |