- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $14,125.38 / $19,054.61
| Facility | | $8,912.51 | $14,125.38 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,125.38 / $17,378.01
| Facility | | $9,772.37 | $14,125.38 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,489.63 / $18,197.01
| Facility | | $9,120.11 | $13,489.63 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,589.25 / $19,498.45
| Facility | | $7,943.28 | $12,589.25 | $19,498.45 |