- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.20 / $10,379.29 / $16,848.80
| Facility | | $7,117.20 | $10,379.29 | $16,848.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,948.79 / $11,948.79 / $11,948.79
| Facility | | $11,948.79 | $11,948.79 | $11,948.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,701.78 / $26,587.37 / $34,086.37
| Facility | | $18,701.78 | $26,587.37 | $34,086.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,357.27 / $16,157.99 / $20,436.93
| Facility | | $8,357.27 | $16,157.99 | $20,436.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,425.61 / $11,162.10 / $17,848.80
| Facility | | $7,425.61 | $11,162.10 | $17,848.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,684.17 / $14,850.04 / $22,561.52
| Facility | | $8,684.17 | $14,850.04 | $22,561.52 |