- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,368.94 / $14,539.40 / $23,275.50
| Facility | | $9,368.94 | $14,539.40 | $23,275.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,159.50 / $9,159.50 / $9,159.50
| Facility | | $9,159.50 | $9,159.50 | $9,159.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.97 / $11,661.32 / $16,423.00
| Facility | | $5,948.97 | $11,661.32 | $16,423.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,657.54 / $11,598.56 / $20,322.22
| Facility | | $8,657.54 | $11,598.56 | $20,322.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,501.01 / $13,135.48 / $17,601.93
| Facility | | $8,501.01 | $13,135.48 | $17,601.93 |