- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $15,135.61
| Facility | | $9,549.93 | $13,182.57 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $10,964.78
| Facility | | $10,964.78 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $12,589.25 / $16,595.87
| Facility | | $7,244.36 | $12,589.25 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,549.93 / $23,442.29
| Facility | | $6,309.57 | $9,549.93 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,332.54 / $13,803.84
| Facility | | $6,456.54 | $9,332.54 | $13,803.84 |