- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,913.58 / $13,832.80 / $22,144.20
| Facility | | $8,913.58 | $13,832.80 | $22,144.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,663.06 / $8,663.06 / $8,663.06
| Facility | | $8,663.06 | $8,663.06 | $8,663.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,626.53 / $10,945.46 / $15,532.85
| Facility | | $5,626.53 | $10,945.46 | $15,532.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,236.76 / $11,034.84 / $19,334.50
| Facility | | $8,236.76 | $11,034.84 | $19,334.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,087.83 / $12,497.06 / $16,746.43
| Facility | | $8,087.83 | $12,497.06 | $16,746.43 |