- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,589.25 / $16,982.44
| Facility | | $7,943.28 | $12,589.25 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $19,498.45 / $23,988.33
| Facility | | $13,182.57 | $19,498.45 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,022.64 / $15,848.93
| Facility | | $8,128.31 | $12,022.64 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $11,220.18 / $17,378.01
| Facility | | $7,079.46 | $11,220.18 | $17,378.01 |