- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,383.50 / $16,623.30 / $21,848.70
| Facility | | $11,383.50 | $16,623.30 | $21,848.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,072.64 / $12,072.64 / $12,072.64
| Facility | | $12,072.64 | $12,072.64 | $12,072.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,668.95 / $18,162.07 / $30,718.70
| Facility | | $6,668.95 | $18,162.07 | $30,718.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,564.05 / $16,697.12 / $27,947.21
| Facility | | $11,564.05 | $16,697.12 | $27,947.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,318.86 / $18,634.21 / $27,207.47
| Facility | | $14,318.86 | $18,634.21 | $27,207.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,494.60 / $16,295.96 / $27,207.47
| Facility | | $9,494.60 | $16,295.96 | $27,207.47 |