- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,333.04 / $14,480.50 / $23,315.50
| Facility | | $6,333.04 | $14,480.50 | $23,315.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,037.73 / $13,037.73 / $13,037.73
| Facility | | $13,037.73 | $13,037.73 | $13,037.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,668.21 / $20,399.99
| Facility | | $1,474.01 | $7,668.21 | $20,399.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,482.02 / $14,340.84 / $21,448.06
| Facility | | $10,482.02 | $14,340.84 | $21,448.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,162.44 / $12,698.59 / $26,668.60
| Facility | | $9,162.44 | $12,698.59 | $26,668.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,602.58 / $12,698.59 / $27,012.94
| Facility | | $8,602.58 | $12,698.59 | $27,012.94 |