- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,273.84 / $12,159.60 / $18,773.40
| Facility | | $8,273.84 | $12,159.60 | $18,773.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,778.73 / $15,778.73 / $18,303.06
| Facility | | $15,778.73 | $15,778.73 | $18,303.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,515.88 / $20,636.49 / $26,457.04
| Facility | | $14,515.88 | $20,636.49 | $26,457.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,311.92 / $18,003.72 / $22,771.45
| Facility | | $9,311.92 | $18,003.72 | $22,771.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,273.84 / $12,437.20 / $19,887.59
| Facility | | $8,273.84 | $12,437.20 | $19,887.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,676.17 / $16,546.36 / $25,138.73
| Facility | | $9,676.17 | $16,546.36 | $25,138.73 |