- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,371.20 / $17,703.20 / $28,775.10
| Facility | | $10,371.20 | $17,703.20 | $28,775.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,066.23 / $18,066.23 / $18,392.15
| Facility | | $18,066.23 | $18,066.23 | $18,392.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,946.73 / $14,066.06 / $22,190.58
| Facility | | $8,946.73 | $14,066.06 | $22,190.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,076.10 / $12,029.20 / $25,480.30
| Facility | | $5,076.10 | $12,029.20 | $25,480.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $14,896.78 / $20,208.08
| Facility | | $6,289.00 | $14,896.78 | $20,208.08 |