- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,189.33 / $12,035.40 / $18,581.70
| Facility | | $8,189.33 | $12,035.40 | $18,581.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,100.58 / $36,100.58 / $36,100.58
| Facility | | $36,100.58 | $36,100.58 | $36,100.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,251.41 / $21,682.16 / $27,797.64
| Facility | | $15,251.41 | $21,682.16 | $27,797.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,216.81 / $17,819.83 / $22,538.86
| Facility | | $9,216.81 | $17,819.83 | $22,538.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,189.33 / $12,310.20 / $19,684.50
| Facility | | $8,189.33 | $12,310.20 | $19,684.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,343.04 / $16,377.36 / $24,881.96
| Facility | | $10,343.04 | $16,377.36 | $24,881.96 |