- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $14,454.40 / $17,782.79
| Facility | | $6,309.57 | $14,454.40 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,471.29 / $10,471.29
| Facility | | $10,471.29 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,498.45 / $31,622.78
| Facility | | $12,589.25 | $19,498.45 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,454.40 / $30,902.95
| Facility | | $10,715.19 | $14,454.40 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $13,803.84 / $26,915.35
| Facility | | $9,332.54 | $13,803.84 | $26,915.35 |