- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,674.79 / $9,891.76 / $20,102.70
| Facility | | $7,674.79 | $9,891.76 | $20,102.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,360.97 / $11,360.97 / $11,763.35
| Facility | | $11,360.97 | $11,360.97 | $11,763.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,817.81 / $9,799.79 / $11,203.69
| Facility | | $7,817.81 | $9,799.79 | $11,203.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,126.12 / $10,843.88 / $14,102.93
| Facility | | $6,126.12 | $10,843.88 | $14,102.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,091.44 / $14,091.44 / $14,091.44
| Facility | | $14,091.44 | $14,091.44 | $14,091.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $8,696.52 / $13,392.86
| Facility | | $1,286.00 | $8,696.52 | $13,392.86 |