- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $11,220.18 / $13,489.63
| Facility | | $9,332.54 | $11,220.18 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $16,218.10
| Facility | | $13,803.84 | $13,803.84 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $11,481.54 / $17,782.79
| Facility | | $8,912.51 | $11,481.54 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $15,135.61 / $15,135.61
| Facility | | $7,079.46 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,882.50 / $19,054.61
| Facility | | $9,120.11 | $12,882.50 | $19,054.61 |