- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,856.62 / $12,428.20 / $19,523.20
| Facility | | $8,856.62 | $12,428.20 | $19,523.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,551.28 / $11,551.28 / $11,551.28
| Facility | | $11,551.28 | $11,551.28 | $11,551.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,206.62 / $11,187.29 / $16,794.08
| Facility | | $7,206.62 | $11,187.29 | $16,794.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,726.26 / $10,666.57 / $19,306.00
| Facility | | $7,726.26 | $10,666.57 | $19,306.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.13 / $113.65 / $184.00
| Facility | | $82.13 | $113.65 | $184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,510.08 / $11,777.63 / $19,383.22
| Facility | | $8,510.08 | $11,777.63 | $19,383.22 |