- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,815.48 / $15,417.50 / $25,596.70
| Facility | | $8,815.48 | $15,417.50 | $25,596.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,953.79 / $12,953.79 / $12,953.79
| Facility | | $12,953.79 | $12,953.79 | $12,953.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,365.60 / $14,030.22 / $23,767.49
| Facility | | $9,365.60 | $14,030.22 | $23,767.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,289.38 / $16,444.50 / $24,213.00
| Facility | | $13,289.38 | $16,444.50 | $24,213.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,261.25 / $16,509.28 / $41,879.26
| Facility | | $8,261.25 | $16,509.28 | $41,879.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,261.25 / $15,762.47 / $22,153.37
| Facility | | $8,261.25 | $15,762.47 | $22,153.37 |