- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,406.81 / $12,124.10 / $24,639.40
| Facility | | $9,406.81 | $12,124.10 | $24,639.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,159.43 / $8,159.43 / $8,159.43
| Facility | | $8,159.43 | $8,159.43 | $8,159.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,629.73 / $12,071.07 / $13,800.35
| Facility | | $9,629.73 | $12,071.07 | $13,800.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,508.64 / $13,291.09 / $17,285.63
| Facility | | $7,508.64 | $13,291.09 | $17,285.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $12,076.84 / $16,978.46
| Facility | | $1,518.00 | $12,076.84 | $16,978.46 |