- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,220.18 / $19,952.62
| Facility | | $8,128.31 | $11,220.18 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $11,481.54 / $11,481.54
| Facility | | $11,481.54 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,232.93 / $15,488.17
| Facility | | $6,456.54 | $10,232.93 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $9,772.37 / $17,378.01
| Facility | | $7,079.46 | $9,772.37 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $109.65 / $173.78
| Facility | | $77.62 | $109.65 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,964.78 / $15,848.93
| Facility | | $7,413.10 | $10,964.78 | $15,848.93 |