- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $9,332.54 / $12,589.25
| Facility | | $3,630.78 | $9,332.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $27,542.29 / $27,542.29
| Facility | | $27,542.29 | $27,542.29 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,232.93 / $11,748.98
| Facility | | $7,585.78 | $10,232.93 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $9,772.37 / $13,803.84
| Facility | | $7,943.28 | $9,772.37 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,165.95 / $12,022.64
| Facility | | $1,819.70 | $6,165.95 | $12,022.64 |