- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,384.60 / $9,310.87 / $15,114.50
| Facility | | $6,384.60 | $9,310.87 | $15,114.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,629.46 / $14,629.46 / $14,629.46
| Facility | | $14,629.46 | $14,629.46 | $14,629.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,551.20 / $17,843.40 / $22,876.16
| Facility | | $12,551.20 | $17,843.40 | $22,876.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,497.02 / $14,494.79 / $18,333.28
| Facility | | $7,497.02 | $14,494.79 | $18,333.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,661.27 / $10,013.20 / $16,011.50
| Facility | | $6,661.27 | $10,013.20 | $16,011.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,790.28 / $13,321.47 / $20,239.18
| Facility | | $7,790.28 | $13,321.47 | $20,239.18 |