- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,963.69 / $13,173.50 / $20,338.70
| Facility | | $8,963.69 | $13,173.50 | $20,338.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,112.05 / $16,112.05 / $16,112.05
| Facility | | $16,112.05 | $16,112.05 | $16,112.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,517.30 / $19,216.87 / $24,637.01
| Facility | | $13,517.30 | $19,216.87 | $24,637.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,088.32 / $19,504.83 / $24,670.08
| Facility | | $10,088.32 | $19,504.83 | $24,670.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,963.69 / $13,474.20 / $21,545.80
| Facility | | $8,963.69 | $13,474.20 | $21,545.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,482.94 / $17,925.96 / $27,234.74
| Facility | | $10,482.94 | $17,925.96 | $27,234.74 |