- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,910.04 / $14,471.60 / $19,020.70
| Facility | | $9,910.04 | $14,471.60 | $19,020.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,258.84 / $10,258.84 / $12,753.14
| Facility | | $10,258.84 | $10,258.84 | $12,753.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,909.06 / $10,645.85 / $18,006.02
| Facility | | $3,909.06 | $10,645.85 | $18,006.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,067.26 / $14,535.94 / $24,329.87
| Facility | | $10,067.26 | $14,535.94 | $24,329.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,465.50 / $16,222.30 / $23,685.88
| Facility | | $12,465.50 | $16,222.30 | $23,685.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,465.50 / $15,080.79 / $23,685.88
| Facility | | $12,465.50 | $15,080.79 | $23,685.88 |