- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,982.44 / $32,359.37
| Facility | | $10,964.78 | $16,982.44 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $18,620.87
| Facility | | $18,620.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,454.40 / $22,908.68
| Facility | | $9,332.54 | $14,454.40 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $12,022.64 / $22,908.68
| Facility | | $5,754.40 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,595.87 / $22,387.21
| Facility | | $10,471.29 | $16,595.87 | $22,387.21 |