- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,162.47 / $18,663.50 / $30,050.60
| Facility | | $8,162.47 | $18,663.50 | $30,050.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,260.69 / $16,260.69 / $16,260.69
| Facility | | $16,260.69 | $16,260.69 | $16,260.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,263.24 / $25,120.73
| Facility | | $1,474.01 | $11,263.24 | $25,120.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,509.97 / $19,513.89 / $27,643.77
| Facility | | $13,509.97 | $19,513.89 | $27,643.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,809.20 / $19,864.00 / $34,372.37
| Facility | | $11,809.20 | $19,864.00 | $34,372.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,990.00 / $19,864.00 / $29,507.48
| Facility | | $11,990.00 | $19,864.00 | $29,507.48 |