- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,153.30 / $10,512.80 / $16,230.90
| Facility | | $7,153.30 | $10,512.80 | $16,230.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,543.79 / $14,543.79 / $14,543.79
| Facility | | $14,543.79 | $14,543.79 | $14,543.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,328.95 / $18,949.09 / $24,293.71
| Facility | | $13,328.95 | $18,949.09 | $24,293.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,050.79 / $15,565.45 / $19,687.48
| Facility | | $8,050.79 | $15,565.45 | $19,687.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,153.30 / $10,752.80 / $17,194.20
| Facility | | $7,153.30 | $10,752.80 | $17,194.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,365.70 / $14,305.46 / $21,734.15
| Facility | | $8,365.70 | $14,305.46 | $21,734.15 |