- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,849.03 / $14,382.50 / $18,903.59
| Facility | | $9,849.03 | $14,382.50 | $18,903.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,579.65 / $10,579.65 / $10,579.65
| Facility | | $10,579.65 | $10,579.65 | $10,579.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,330.27 / $11,792.96 / $19,946.20
| Facility | | $4,330.27 | $11,792.96 | $19,946.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,005.27 / $14,446.43 / $24,180.06
| Facility | | $10,005.27 | $14,446.43 | $24,180.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,388.74 / $16,122.41 / $23,540.03
| Facility | | $12,388.74 | $16,122.41 | $23,540.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,388.74 / $14,987.93 / $23,540.03
| Facility | | $12,388.74 | $14,987.93 | $23,540.03 |