- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,773.60 / $11,336.50 / $18,402.70
| Facility | | $7,773.60 | $11,336.50 | $18,402.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,986.68 / $13,019.80 / $18,617.77
| Facility | | $12,986.68 | $13,019.80 | $18,617.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,760.83 / $30,936.27 / $39,661.87
| Facility | | $21,760.83 | $30,936.27 | $39,661.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,128.03 / $17,648.20 / $22,321.78
| Facility | | $9,128.03 | $17,648.20 | $22,321.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,110.46 / $12,191.60 / $19,494.90
| Facility | | $8,110.46 | $12,191.60 | $19,494.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,485.09 / $16,219.62 / $24,642.31
| Facility | | $9,485.09 | $16,219.62 | $24,642.31 |