- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,979.80 / $10,178.90 / $16,523.50
| Facility | | $6,979.80 | $10,178.90 | $16,523.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,620.89 / $16,620.89 / $16,620.89
| Facility | | $16,620.89 | $16,620.89 | $16,620.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,482.01 / $10,636.80 / $13,636.92
| Facility | | $7,482.01 | $10,636.80 | $13,636.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,195.93 / $15,846.05 / $20,042.39
| Facility | | $8,195.93 | $15,846.05 | $20,042.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,282.26 / $10,946.70 / $17,504.20
| Facility | | $7,282.26 | $10,946.70 | $17,504.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,584.43 / $14,563.35 / $22,125.97
| Facility | | $9,584.43 | $14,563.35 | $22,125.97 |