- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,721.70 / $16,411.80 / $28,880.10
| Facility | | $9,721.70 | $16,411.80 | $28,880.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,460.96 / $6,303.67 / $10,284.14
| Facility | | $4,460.96 | $6,303.67 | $10,284.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,843.41 / $15,127.70 / $20,888.65
| Facility | | $8,843.41 | $15,127.70 | $20,888.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,824.80 / $30,824.80 / $36,175.51
| Facility | | $30,824.80 | $30,824.80 | $36,175.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,013.11 / $20,429.87
| Facility | | $1,787.00 | $14,013.11 | $20,429.87 |