- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,448.46 / $15,673.40 / $21,032.50
| Facility | | $9,448.46 | $15,673.40 | $21,032.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,797.65 / $11,797.65 / $11,797.65
| Facility | | $11,797.65 | $11,797.65 | $11,797.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,692.70 / $14,852.10 / $23,354.10
| Facility | | $8,692.70 | $14,852.10 | $23,354.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,758.47 / $12,619.50 / $28,941.56
| Facility | | $7,758.47 | $12,619.50 | $28,941.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,211.39 / $12,431.05 / $17,610.09
| Facility | | $9,211.39 | $12,431.05 | $17,610.09 |