- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $13,489.63 / $18,197.01
| Facility | | $5,370.32 | $13,489.63 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,378.01 / $17,378.01
| Facility | | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,589.25 / $14,454.40
| Facility | | $9,332.54 | $12,589.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $14,454.40 / $19,952.62
| Facility | | $11,481.54 | $14,454.40 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,309.57 / $17,782.79
| Facility | | $1,819.70 | $6,309.57 | $17,782.79 |