- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,635.70 / $14,200.20 / $22,751.60
| Facility | | $10,635.70 | $14,200.20 | $22,751.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,655.41 / $13,425.78 / $19,560.43
| Facility | | $8,655.41 | $13,425.78 | $19,560.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,278.24 / $13,014.34 / $23,184.00
| Facility | | $9,278.24 | $13,014.34 | $23,184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.69 / $123.54 / $196.89
| Facility | | $89.69 | $123.54 | $196.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,696.70 / $14,124.85 / $22,421.25
| Facility | | $9,696.70 | $14,124.85 | $22,421.25 |