- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,680.85 / $13,195.50 / $21,907.60
| Facility | | $9,680.85 | $13,195.50 | $21,907.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,545.79 / $12,545.79 / $12,545.79
| Facility | | $12,545.79 | $12,545.79 | $12,545.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,503.74 / $11,487.04 / $19,095.00
| Facility | | $7,503.74 | $11,487.04 | $19,095.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,374.09 / $14,074.50 / $20,237.41
| Facility | | $11,374.09 | $14,074.50 | $20,237.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,070.63 / $14,129.94 / $33,553.79
| Facility | | $7,070.63 | $14,129.94 | $33,553.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,070.63 / $13,490.75 / $18,960.59
| Facility | | $7,070.63 | $13,490.75 | $18,960.59 |