- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,125.38 / $18,197.01
| Facility | | $10,232.93 | $14,125.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,589.25 / $17,378.01
| Facility | | $8,128.31 | $12,589.25 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $14,791.08 / $20,892.96
| Facility | | $7,762.47 | $14,791.08 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,803.84 / $17,378.01
| Facility | | $8,128.31 | $13,803.84 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $14,791.08 / $20,892.96
| Facility | | $7,585.78 | $14,791.08 | $20,892.96 |