- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.39 / $10,360.10 / $15,995.10
| Facility | | $7,049.39 | $10,360.10 | $15,995.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,669.86 / $25,669.86 / $27,689.94
| Facility | | $25,669.86 | $25,669.86 | $27,689.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,414.81 / $17,649.50 / $22,627.57
| Facility | | $12,414.81 | $17,649.50 | $22,627.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,933.84 / $15,339.33 / $19,401.48
| Facility | | $7,933.84 | $15,339.33 | $19,401.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.39 / $10,596.60 / $16,944.40
| Facility | | $7,049.39 | $10,596.60 | $16,944.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,244.18 / $14,097.65 / $21,418.42
| Facility | | $8,244.18 | $14,097.65 | $21,418.42 |