- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,224.70 / $18,971.20 / $30,370.10
| Facility | | $12,224.70 | $18,971.20 | $30,370.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,678.79 / $12,678.79 / $12,678.79
| Facility | | $12,678.79 | $12,678.79 | $12,678.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,608.57 / $14,801.18 / $21,004.56
| Facility | | $7,608.57 | $14,801.18 | $21,004.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,296.47 / $15,133.94 / $26,516.68
| Facility | | $11,296.47 | $15,133.94 | $26,516.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,092.22 / $17,391.00 / $23,470.25
| Facility | | $11,092.22 | $17,391.00 | $23,470.25 |