- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,903.79 / $12,265.70 / $19,635.59
| Facility | | $7,903.79 | $12,265.70 | $19,635.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,365.96 / $8,365.96 / $8,365.96
| Facility | | $8,365.96 | $8,365.96 | $8,365.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,049.55 / $9,823.04 / $13,940.02
| Facility | | $5,049.55 | $9,823.04 | $13,940.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,303.65 / $9,784.74 / $17,144.16
| Facility | | $7,303.65 | $9,784.74 | $17,144.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,171.59 / $11,081.31 / $14,849.29
| Facility | | $7,171.59 | $11,081.31 | $14,849.29 |