- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,135.61 / $17,378.01
| Facility | | $10,964.78 | $15,135.61 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $16,218.10
| Facility | | $14,125.38 | $14,125.38 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $14,454.40 / $19,054.61
| Facility | | $8,317.64 | $14,454.40 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,964.78 / $27,542.29
| Facility | | $7,244.36 | $10,964.78 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,964.78 / $16,218.10
| Facility | | $7,413.10 | $10,964.78 | $16,218.10 |