- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,608.33 / $11,402.90 / $19,950.80
| Facility | | $8,608.33 | $11,402.90 | $19,950.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,054.62 / $9,054.62 / $9,054.62
| Facility | | $9,054.62 | $9,054.62 | $9,054.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $10,278.29 / $19,393.45
| Facility | | $5,843.91 | $10,278.29 | $19,393.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,257.12 / $14,020.48 / $24,768.00
| Facility | | $8,257.12 | $14,020.48 | $24,768.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $12,987.71 / $17,948.59
| Facility | | $3,496.00 | $12,987.71 | $17,948.59 |