- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,935.57 / $14,508.90 / $19,069.70
| Facility | | $9,935.57 | $14,508.90 | $19,069.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,480.71 / $10,480.71 / $12,478.63
| Facility | | $10,480.71 | $10,480.71 | $12,478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,918.44 / $10,671.40 / $18,049.23
| Facility | | $3,918.44 | $10,671.40 | $18,049.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,093.18 / $14,573.37 / $24,392.52
| Facility | | $10,093.18 | $14,573.37 | $24,392.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,497.60 / $16,264.07 / $23,746.87
| Facility | | $12,497.60 | $16,264.07 | $23,746.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,497.60 / $15,119.62 / $23,746.87
| Facility | | $12,497.60 | $15,119.62 | $23,746.87 |