- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $14,454.40 / $21,877.62
| Facility | | $11,220.18 | $14,454.40 | $21,877.62 |
- 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
- $6,918.31 / $13,803.84 / $20,892.96
| Facility | | $6,918.31 | $13,803.84 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,481.54 / $21,379.62
| Facility | | $8,317.64 | $11,481.54 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $10,715.19 / $17,378.01
| Facility | | $3,311.31 | $10,715.19 | $17,378.01 |