- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,431.12 / $14,706.70 / $18,739.50
| Facility | | $9,431.12 | $14,706.70 | $18,739.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,924.08 / $14,924.08 / $14,924.08
| Facility | | $14,924.08 | $14,924.08 | $14,924.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,389.69 / $15,065.12 / $17,744.75
| Facility | | $8,389.69 | $15,065.12 | $17,744.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,027.26 / $15,278.42 / $21,403.94
| Facility | | $8,027.26 | $15,278.42 | $21,403.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,518.44 / $16,666.63 / $21,403.94
| Facility | | $14,518.44 | $16,666.63 | $21,403.94 |