- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,220.28 / $10,611.30 / $16,382.90
| Facility | | $7,220.28 | $10,611.30 | $16,382.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,523.54 / $13,523.54 / $13,523.54
| Facility | | $13,523.54 | $13,523.54 | $13,523.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,680.27 / $23,713.50 / $30,401.92
| Facility | | $16,680.27 | $23,713.50 | $30,401.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,126.18 / $15,711.20 / $19,871.82
| Facility | | $8,126.18 | $15,711.20 | $19,871.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,220.28 / $10,853.50 / $17,355.20
| Facility | | $7,220.28 | $10,853.50 | $17,355.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,444.04 / $14,439.41 / $21,937.67
| Facility | | $8,444.04 | $14,439.41 | $21,937.67 |