- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,931.46 / $13,042.60 / $17,142.50
| Facility | | $8,931.46 | $13,042.60 | $17,142.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,672.39 / $15,672.39 / $15,672.39
| Facility | | $15,672.39 | $15,672.39 | $15,672.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,169.88 / $16,802.91 / $28,419.87
| Facility | | $6,169.88 | $16,802.91 | $28,419.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,073.16 / $13,100.57 / $21,927.40
| Facility | | $9,073.16 | $13,100.57 | $21,927.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,234.58 / $14,620.41 / $21,346.99
| Facility | | $11,234.58 | $14,620.41 | $21,346.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,234.58 / $13,591.62 / $21,346.99
| Facility | | $11,234.58 | $13,591.62 | $21,346.99 |