- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,638.27 / $12,422.40 / $25,245.70
| Facility | | $9,638.27 | $12,422.40 | $25,245.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,493.82 / $13,493.82 / $13,493.82
| Facility | | $13,493.82 | $13,493.82 | $13,493.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,674.45 / $12,127.14 / $13,864.46
| Facility | | $9,674.45 | $12,127.14 | $13,864.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,693.40 / $13,618.13 / $17,710.96
| Facility | | $7,693.40 | $13,618.13 | $17,710.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,517.89 / $15,517.89 / $15,517.89
| Facility | | $15,517.89 | $15,517.89 | $15,517.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $14,129.23 / $19,154.15
| Facility | | $2,000.00 | $14,129.23 | $19,154.15 |