- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,826.66 / $14,900.90 / $26,221.20
| Facility | | $8,826.66 | $14,900.90 | $26,221.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,849.39 / $14,077.66 / $18,653.27
| Facility | | $8,849.39 | $14,077.66 | $18,653.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,934.55 / $8,738.94 / $14,385.72
| Facility | | $5,934.55 | $8,738.94 | $14,385.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,029.23 / $13,734.96 / $19,111.93
| Facility | | $8,029.23 | $13,734.96 | $19,111.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,349.70 / $28,349.70 / $33,270.78
| Facility | | $28,349.70 | $28,349.70 | $33,270.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,985.98 / $18,548.98
| Facility | | $1,787.00 | $12,985.98 | $18,548.98 |