- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,415.42 / $13,987.50 / $23,222.50
| Facility | | $9,415.42 | $13,987.50 | $23,222.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,422.43 / $6,422.43 / $6,422.43
| Facility | | $6,422.43 | $6,422.43 | $6,422.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,036.50 / $12,039.15 / $20,394.57
| Facility | | $8,036.50 | $12,039.15 | $20,394.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,812.00 / $14,919.25 / $21,452.06
| Facility | | $11,812.00 | $14,919.25 | $21,452.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.00 / $14,331.64 / $35,936.05
| Facility | | $7,495.00 | $14,331.64 | $35,936.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.00 / $14,300.46 / $20,098.59
| Facility | | $7,495.00 | $14,300.46 | $20,098.59 |