- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,540.59 / $13,932.10 / $18,311.59
| Facility | | $9,540.59 | $13,932.10 | $18,311.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,677.42 / $10,076.90 / $16,774.50
| Facility | | $3,677.42 | $10,076.90 | $16,774.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,041.91 / $14,058.51 / $25,076.40
| Facility | | $10,041.91 | $14,058.51 | $25,076.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,000.76 / $15,617.50 / $22,802.83
| Facility | | $12,000.76 | $15,617.50 | $22,802.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,000.76 / $14,518.55 / $22,802.83
| Facility | | $12,000.76 | $14,518.55 | $22,802.83 |