- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $13,182.57 / $18,620.87
| Facility | | $7,585.78 | $13,182.57 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $13,182.57 / $16,218.10
| Facility | | $13,182.57 | $13,182.57 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,302.69 / $18,620.87
| Facility | | $7,762.47 | $12,302.69 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $11,748.98 / $21,379.62
| Facility | | $8,511.38 | $11,748.98 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $144.54 / $229.09
| Facility | | $95.50 | $144.54 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $9,549.93 / $17,782.79
| Facility | | $4,073.80 | $9,549.93 | $17,782.79 |