- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,566.46 / $11,347.50 / $19,853.80
| Facility | | $8,566.46 | $11,347.50 | $19,853.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,629.41 / $16,629.41 / $16,629.41
| Facility | | $16,629.41 | $16,629.41 | $16,629.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,082.47 / $19,040.05
| Facility | | $5,843.91 | $11,082.47 | $19,040.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,168.34 / $12,196.89 / $17,727.38
| Facility | | $8,168.34 | $12,196.89 | $17,727.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $11,694.11 / $17,861.31
| Facility | | $3,496.00 | $11,694.11 | $17,861.31 |