- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,628.62 / $14,313.40 / $19,207.50
| Facility | | $8,628.62 | $14,313.40 | $19,207.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,070.60 / $12,070.60 / $12,070.60
| Facility | | $12,070.60 | $12,070.60 | $12,070.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,999.38 / $12,371.98 / $19,454.25
| Facility | | $6,999.38 | $12,371.98 | $19,454.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,085.26 / $11,524.50 / $26,430.29
| Facility | | $7,085.26 | $11,524.50 | $26,430.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,412.12 / $11,310.14 / $16,082.06
| Facility | | $8,412.12 | $11,310.14 | $16,082.06 |