- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,773.61 / $13,615.60 / $21,796.50
| Facility | | $8,773.61 | $13,615.60 | $21,796.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,489.95 / $8,489.95 / $8,489.95
| Facility | | $8,489.95 | $8,489.95 | $8,489.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,514.10 / $10,726.75 / $15,222.48
| Facility | | $5,514.10 | $10,726.75 | $15,222.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,107.42 / $10,861.56 / $19,030.89
| Facility | | $8,107.42 | $10,861.56 | $19,030.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,960.83 / $12,300.82 / $16,483.46
| Facility | | $7,960.83 | $12,300.82 | $16,483.46 |