- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,744.70 / $13,848.50 / $28,143.70
| Facility | | $10,744.70 | $13,848.50 | $28,143.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,324.46 / $15,324.46 / $15,324.46
| Facility | | $15,324.46 | $15,324.46 | $15,324.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,592.49 / $13,277.91 / $15,180.08
| Facility | | $10,592.49 | $13,277.91 | $15,180.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,576.57 / $15,181.43 / $19,744.09
| Facility | | $8,576.57 | $15,181.43 | $19,744.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $13,794.48 / $19,393.24
| Facility | | $1,518.00 | $13,794.48 | $19,393.24 |