- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.17 / $13,814.60 / $24,309.60
| Facility | | $8,183.17 | $13,814.60 | $24,309.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,691.22 / $11,352.99 / $18,771.54
| Facility | | $7,691.22 | $11,352.99 | $18,771.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,443.88 / $12,733.64 / $17,718.62
| Facility | | $7,443.88 | $12,733.64 | $17,718.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,417.10 / $24,417.10 / $28,655.54
| Facility | | $24,417.10 | $24,417.10 | $28,655.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,039.26 / $17,196.71
| Facility | | $1,787.00 | $12,039.26 | $17,196.71 |