- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,291.24 / $15,412.60 / $20,682.50
| Facility | | $9,291.24 | $15,412.60 | $20,682.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,395.12 / $12,395.12 / $12,395.12
| Facility | | $12,395.12 | $12,395.12 | $12,395.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,375.02 / $12,627.63 / $19,918.93
| Facility | | $7,375.02 | $12,627.63 | $19,918.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,629.36 / $12,409.50 / $28,459.95
| Facility | | $7,629.36 | $12,409.50 | $28,459.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,004.33 / $12,224.18 / $17,317.04
| Facility | | $9,004.33 | $12,224.18 | $17,317.04 |