- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,197.40 / $14,891.30 / $19,572.20
| Facility | | $10,197.40 | $14,891.30 | $19,572.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,883.55 / $12,883.55 / $12,883.55
| Facility | | $12,883.55 | $12,883.55 | $12,883.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,271.23 / $22,525.67 / $38,099.14
| Facility | | $8,271.23 | $22,525.67 | $38,099.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,359.18 / $14,957.43 / $25,035.36
| Facility | | $10,359.18 | $14,957.43 | $25,035.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,826.96 / $16,692.68 / $24,372.69
| Facility | | $12,826.96 | $16,692.68 | $24,372.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,826.96 / $15,518.08 / $24,372.69
| Facility | | $12,826.96 | $15,518.08 | $24,372.69 |