- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,125.38 / $20,417.38
| Facility | | $9,549.93 | $14,125.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $10,232.93 / $10,232.93
| Facility | | $10,232.93 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $14,125.38 / $23,988.33
| Facility | | $5,248.07 | $14,125.38 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $11,481.54 / $19,498.45
| Facility | | $8,511.38 | $11,481.54 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $12,882.50 / $19,054.61
| Facility | | $10,471.29 | $12,882.50 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $12,589.25 / $18,197.01
| Facility | | $6,760.83 | $12,589.25 | $18,197.01 |