- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,001.20 / $8,751.75 / $14,206.80
| Facility | | $6,001.20 | $8,751.75 | $14,206.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,677.39 / $11,677.39 / $12,045.93
| Facility | | $11,677.39 | $11,677.39 | $12,045.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,625.36 / $19,441.31 / $24,829.37
| Facility | | $13,625.36 | $19,441.31 | $24,829.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,046.82 / $13,624.36 / $17,232.36
| Facility | | $7,046.82 | $13,624.36 | $17,232.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,261.25 / $9,411.87 / $15,050.00
| Facility | | $6,261.25 | $9,411.87 | $15,050.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,322.46 / $12,521.50 / $19,023.80
| Facility | | $7,322.46 | $12,521.50 | $19,023.80 |