- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,574.79 / $12,787.50 / $22,502.30
| Facility | | $7,574.79 | $12,787.50 | $22,502.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,999.41 / $14,999.41 / $14,999.41
| Facility | | $14,999.41 | $14,999.41 | $14,999.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,998.93 / $5,854.61 / $9,680.27
| Facility | | $3,998.93 | $5,854.61 | $9,680.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,890.45 / $11,786.94 / $16,618.55
| Facility | | $6,890.45 | $11,786.94 | $16,618.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,901.30 / $22,901.30 / $26,876.62
| Facility | | $22,901.30 | $22,901.30 | $26,876.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $11,144.19 / $15,918.20
| Facility | | $1,787.00 | $11,144.19 | $15,918.20 |