- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,460.34 / $12,852.70 / $20,237.40
| Facility | | $9,460.34 | $12,852.70 | $20,237.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,699.50 / $11,952.43 / $17,807.43
| Facility | | $7,699.50 | $11,952.43 | $17,807.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,252.92 / $11,393.66 / $20,622.00
| Facility | | $8,252.92 | $11,393.66 | $20,622.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.72 / $120.83 / $192.58
| Facility | | $87.72 | $120.83 | $192.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,090.18 / $12,580.45 / $20,704.49
| Facility | | $9,090.18 | $12,580.45 | $20,704.49 |