- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,943.09 / $14,835.10 / $19,907.50
| Facility | | $8,943.09 | $14,835.10 | $19,907.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,623.78 / $16,623.78 / $16,623.78
| Facility | | $16,623.78 | $16,623.78 | $16,623.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,101.86 / $12,530.89 / $19,719.08
| Facility | | $7,101.86 | $12,530.89 | $19,719.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,343.48 / $11,944.50 / $27,393.52
| Facility | | $7,343.48 | $11,944.50 | $27,393.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,666.93 / $11,766.13 / $16,873.59
| Facility | | $8,666.93 | $11,766.13 | $16,873.59 |