- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,718.93 / $10,486.80 / $16,512.20
| Facility | | $7,718.93 | $10,486.80 | $16,512.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,764.13 / $18,764.13 / $18,764.13
| Facility | | $18,764.13 | $18,764.13 | $18,764.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,106.26 / $9,711.31 / $14,917.50
| Facility | | $6,106.26 | $9,711.31 | $14,917.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,733.77 / $9,445.28 / $16,974.00
| Facility | | $6,733.77 | $9,445.28 | $16,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.67 / $88.13 / $141.97
| Facility | | $60.67 | $88.13 | $141.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,416.90 / $10,264.70 / $16,893.30
| Facility | | $7,416.90 | $10,264.70 | $16,893.30 |