- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,135.61 / $18,197.01
| Facility | | $12,589.25 | $15,135.61 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,803.84 / $21,877.62
| Facility | | $13,489.63 | $13,803.84 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $15,488.17 / $24,547.09
| Facility | | $12,022.64 | $15,488.17 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $20,892.96 / $20,892.96
| Facility | | $9,772.37 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $17,378.01 / $26,302.68
| Facility | | $12,589.25 | $17,378.01 | $26,302.68 |