- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,274.46 / $12,160.60 / $18,774.80
| Facility | | $8,274.46 | $12,160.60 | $18,774.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,711.27 / $12,711.27 / $12,711.27
| Facility | | $12,711.27 | $12,711.27 | $12,711.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,434.25 / $29,050.36 / $37,244.05
| Facility | | $20,434.25 | $29,050.36 | $37,244.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,312.62 / $18,005.08 / $22,773.17
| Facility | | $9,312.62 | $18,005.08 | $22,773.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,274.46 / $12,438.10 / $19,889.09
| Facility | | $8,274.46 | $12,438.10 | $19,889.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,676.90 / $16,547.61 / $25,140.64
| Facility | | $9,676.90 | $16,547.61 | $25,140.64 |