- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,595.87 / $25,118.86
| Facility | | $12,022.64 | $16,595.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $19,054.61
| Facility | | $13,489.63 | $13,489.63 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,791.08 / $21,877.62
| Facility | | $9,120.11 | $14,791.08 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,454.40 / $25,703.96
| Facility | | $10,471.29 | $14,454.40 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $162.18 / $245.47
| Facility | | $109.65 | $162.18 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $23,988.33
| Facility | | $10,715.19 | $16,218.10 | $23,988.33 |