- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,595.87 / $23,442.29
| Facility | | $10,964.78 | $16,595.87 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $11,748.98
| Facility | | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $9,332.54 / $15,488.17
| Facility | | $3,467.37 | $9,332.54 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,125.38 / $25,118.86
| Facility | | $9,772.37 | $14,125.38 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $15,488.17 / $21,877.62
| Facility | | $12,022.64 | $15,488.17 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $14,791.08 / $22,387.21
| Facility | | $7,762.47 | $14,791.08 | $22,387.21 |