- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,924.53 / $11,646.30 / $17,980.80
| Facility | | $7,924.53 | $11,646.30 | $17,980.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,473.49 / $22,473.49 / $22,473.49
| Facility | | $22,473.49 | $22,473.49 | $22,473.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,710.52 / $19,491.55 / $24,989.17
| Facility | | $13,710.52 | $19,491.55 | $24,989.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,918.78 / $17,243.63 / $21,810.08
| Facility | | $8,918.78 | $17,243.63 | $21,810.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,924.53 / $11,912.10 / $19,048.00
| Facility | | $7,924.53 | $11,912.10 | $19,048.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,267.65 / $15,847.80 / $24,077.42
| Facility | | $9,267.65 | $15,847.80 | $24,077.42 |