- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,779.12 / $14,563.10 / $19,542.50
| Facility | | $8,779.12 | $14,563.10 | $19,542.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,638.63 / $10,638.63 / $10,638.63
| Facility | | $10,638.63 | $10,638.63 | $10,638.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,966.18 / $12,343.77 / $19,521.71
| Facility | | $6,966.18 | $12,343.77 | $19,521.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,208.84 / $11,725.50 / $26,891.26
| Facility | | $7,208.84 | $11,725.50 | $26,891.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,153.70 / $11,346.38 / $16,225.75
| Facility | | $9,153.70 | $11,346.38 | $16,225.75 |