- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,419.65 / $13,755.50 / $18,079.50
| Facility | | $9,419.65 | $13,755.50 | $18,079.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,714.76 / $12,714.76 / $18,627.38
| Facility | | $12,714.76 | $12,714.76 | $18,627.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,533.85 / $15,070.77 / $25,490.17
| Facility | | $5,533.85 | $15,070.77 | $25,490.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,569.08 / $13,816.63 / $23,125.91
| Facility | | $9,569.08 | $13,816.63 | $23,125.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,848.64 / $15,419.54 / $22,513.78
| Facility | | $11,848.64 | $15,419.54 | $22,513.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,848.64 / $14,334.52 / $22,513.78
| Facility | | $11,848.64 | $14,334.52 | $22,513.78 |