- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,261.10 / $18,680.30 / $25,067.50
| Facility | | $11,261.10 | $18,680.30 | $25,067.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,195.34 / $10,195.34 / $10,195.34
| Facility | | $10,195.34 | $10,195.34 | $10,195.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,643.56 / $16,800.66 / $26,881.70
| Facility | | $8,643.56 | $16,800.66 | $26,881.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,246.90 / $15,040.50 / $34,493.87
| Facility | | $9,246.90 | $15,040.50 | $34,493.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,978.56 / $14,815.90 / $20,988.52
| Facility | | $10,978.56 | $14,815.90 | $20,988.52 |