- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,882.50 / $16,982.44
| Facility | | $7,943.28 | $12,882.50 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,125.38 / $17,378.01
| Facility | | $9,549.93 | $14,125.38 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,302.69 / $16,218.10
| Facility | | $8,317.64 | $12,302.69 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $17,782.79
| Facility | | $7,244.36 | $11,220.18 | $17,782.79 |