- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,777.80 / $11,342.60 / $18,412.59
| Facility | | $7,777.80 | $11,342.60 | $18,412.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,866.50 / $13,866.50 / $13,866.50
| Facility | | $13,866.50 | $13,866.50 | $13,866.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,713.57 / $18,074.24 / $23,172.10
| Facility | | $12,713.57 | $18,074.24 | $23,172.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,132.95 / $17,809.61 / $25,870.26
| Facility | | $9,132.95 | $17,809.61 | $25,870.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,114.84 / $12,198.20 / $19,505.40
| Facility | | $8,114.84 | $12,198.20 | $19,505.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,490.20 / $16,228.38 / $24,655.63
| Facility | | $9,490.20 | $16,228.38 | $24,655.63 |