- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $10,964.78 / $16,595.87
| Facility | | $8,511.38 | $10,964.78 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $14,791.08 / $14,791.08
| Facility | | $14,791.08 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $10,715.19 / $15,848.93
| Facility | | $5,370.32 | $10,715.19 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $8,709.64 / $16,218.10
| Facility | | $6,309.57 | $8,709.64 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $8,912.51 / $13,182.57
| Facility | | $3,162.28 | $8,912.51 | $13,182.57 |