- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,139.20 / $12,631.00 / $20,220.40
| Facility | | $8,139.20 | $12,631.00 | $20,220.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,853.78 / $7,853.78 / $7,853.78
| Facility | | $7,853.78 | $7,853.78 | $7,853.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,100.91 / $9,922.95 / $14,081.81
| Facility | | $5,100.91 | $9,922.95 | $14,081.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,521.18 / $10,076.17 / $17,654.78
| Facility | | $7,521.18 | $10,076.17 | $17,654.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,385.19 / $11,411.36 / $15,291.56
| Facility | | $7,385.19 | $11,411.36 | $15,291.56 |