- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,619.32 / $9,728.08 / $15,019.30
| Facility | | $6,619.32 | $9,728.08 | $15,019.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,503.49 / $13,503.49 / $13,503.49
| Facility | | $13,503.49 | $13,503.49 | $13,503.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,756.19 / $20,978.12 / $26,895.03
| Facility | | $14,756.19 | $20,978.12 | $26,895.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,449.82 / $14,403.52 / $18,217.84
| Facility | | $7,449.82 | $14,403.52 | $18,217.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,619.32 / $9,950.12 / $15,910.70
| Facility | | $6,619.32 | $9,950.12 | $15,910.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,741.23 / $13,237.59 / $20,111.75
| Facility | | $7,741.23 | $13,237.59 | $20,111.75 |