- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,443.91 / $14,254.70 / $25,084.20
| Facility | | $8,443.91 | $14,254.70 | $25,084.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,641.80 / $16,641.80 / $16,641.80
| Facility | | $16,641.80 | $16,641.80 | $16,641.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,659.82 / $12,332.50 / $20,401.33
| Facility | | $8,659.82 | $12,332.50 | $20,401.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,681.06 / $13,139.37 / $18,283.18
| Facility | | $7,681.06 | $13,139.37 | $18,283.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,875.35 / $27,875.35 / $32,714.09
| Facility | | $27,875.35 | $27,875.35 | $32,714.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,422.87 / $17,744.64
| Facility | | $1,787.00 | $12,422.87 | $17,744.64 |