- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,678.54 / $14,065.20 / $19,914.90
| Facility | | $7,678.54 | $14,065.20 | $19,914.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,080.57 / $15,080.57 / $15,080.57
| Facility | | $15,080.57 | $15,080.57 | $15,080.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,583.62 / $13,921.24 / $22,390.05
| Facility | | $8,583.62 | $13,921.24 | $22,390.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,983.36 / $12,652.42 / $22,510.66
| Facility | | $7,983.36 | $12,652.42 | $22,510.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $12,041.26 / $26,618.89
| Facility | | $5,264.00 | $12,041.26 | $26,618.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $11,677.48 / $23,654.94
| Facility | | $3,308.00 | $11,677.48 | $23,654.94 |