- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,688.09 / $15,292.30 / $24,622.60
| Facility | | $6,688.09 | $15,292.30 | $24,622.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,458.30 / $13,458.30 / $13,458.30
| Facility | | $13,458.30 | $13,458.30 | $13,458.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $8,640.15 / $20,970.14
| Facility | | $1,474.01 | $8,640.15 | $20,970.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,069.68 / $15,989.11 / $22,650.50
| Facility | | $11,069.68 | $15,989.11 | $22,650.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,676.12 / $13,410.51 / $28,163.73
| Facility | | $9,676.12 | $13,410.51 | $28,163.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,084.87 / $13,410.51 / $28,527.37
| Facility | | $9,084.87 | $13,410.51 | $28,527.37 |