- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,670.50 / $13,343.80 / $22,332.70
| Facility | | $9,670.50 | $13,343.80 | $22,332.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,453.91 / $16,453.91 / $16,453.91
| Facility | | $16,453.91 | $16,453.91 | $16,453.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,272.00 / $15,266.27 / $23,310.51
| Facility | | $3,272.00 | $15,266.27 | $23,310.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,897.68 / $15,012.30 / $25,175.54
| Facility | | $9,897.68 | $15,012.30 | $25,175.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $15,308.56 / $26,940.79
| Facility | | $4,062.00 | $15,308.56 | $26,940.79 |