- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,203.73 / $12,731.20 / $20,380.70
| Facility | | $8,203.73 | $12,731.20 | $20,380.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,871.44 / $13,871.44 / $14,004.65
| Facility | | $13,871.44 | $13,871.44 | $14,004.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,260.14 / $10,181.09 / $14,521.38
| Facility | | $5,260.14 | $10,181.09 | $14,521.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,580.81 / $10,156.06 / $17,794.75
| Facility | | $7,580.81 | $10,156.06 | $17,794.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,443.74 / $11,501.83 / $15,412.80
| Facility | | $7,443.74 | $11,501.83 | $15,412.80 |