- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,406.20 / $13,717.40 / $22,267.60
| Facility | | $9,406.20 | $13,717.40 | $22,267.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,114.36 / $17,114.36 / $17,114.36
| Facility | | $17,114.36 | $17,114.36 | $17,114.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,285.91 / $24,574.50 / $31,505.77
| Facility | | $17,285.91 | $24,574.50 | $31,505.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,045.09 / $21,538.32 / $31,286.59
| Facility | | $11,045.09 | $21,538.32 | $31,286.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,813.79 / $14,752.10 / $23,589.20
| Facility | | $9,813.79 | $14,752.10 | $23,589.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.13 / $19,626.04 / $29,817.65
| Facility | | $11,477.13 | $19,626.04 | $29,817.65 |