- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,057.20 / $16,683.20 / $22,387.50
| Facility | | $10,057.20 | $16,683.20 | $22,387.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,637.26 / $14,637.26 / $14,637.26
| Facility | | $14,637.26 | $14,637.26 | $14,637.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,968.22 / $13,957.58 / $22,329.80
| Facility | | $7,968.22 | $13,957.58 | $22,329.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,258.29 / $13,432.50 / $30,806.10
| Facility | | $8,258.29 | $13,432.50 | $30,806.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,786.21 / $13,231.91 / $18,744.61
| Facility | | $9,786.21 | $13,231.91 | $18,744.61 |