- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,826.85 / $15,288.50 / $23,306.40
| Facility | | $7,826.85 | $15,288.50 | $23,306.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,585.56 / $14,585.56 / $14,585.56
| Facility | | $14,585.56 | $14,585.56 | $14,585.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,098.31 / $16,434.22 / $25,782.54
| Facility | | $10,098.31 | $16,434.22 | $25,782.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,342.95 / $9,342.95 / $9,342.95
| Facility | | $9,342.95 | $9,342.95 | $9,342.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,379.28 / $14,364.09 / $31,152.20
| Facility | | $5,379.28 | $14,364.09 | $31,152.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,666.20 / $27,683.47
| Facility | | $3,308.00 | $13,666.20 | $27,683.47 |