- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,946.40 / $15,397.30 / $31,291.50
| Facility | | $11,946.40 | $15,397.30 | $31,291.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,352.82 / $11,352.82 / $11,352.82
| Facility | | $11,352.82 | $11,352.82 | $11,352.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,363.55 / $14,244.45 / $16,285.09
| Facility | | $11,363.55 | $14,244.45 | $16,285.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,535.81 / $16,879.39 / $21,952.37
| Facility | | $9,535.81 | $16,879.39 | $21,952.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,055.74 / $13,055.74 / $13,055.74
| Facility | | $13,055.74 | $13,055.74 | $13,055.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $13,536.85 / $20,847.09
| Facility | | $1,286.00 | $13,536.85 | $20,847.09 |