- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,061.80 / $8,840.12 / $14,350.30
| Facility | | $6,061.80 | $8,840.12 | $14,350.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,058.94 / $12,248.16 / $15,946.16
| Facility | | $10,058.94 | $12,248.16 | $15,946.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,142.63 / $21,527.50 / $27,599.36
| Facility | | $15,142.63 | $21,527.50 | $27,599.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.98 / $13,761.94 / $17,406.37
| Facility | | $7,117.98 | $13,761.94 | $17,406.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,324.48 / $9,506.92 / $15,202.00
| Facility | | $6,324.48 | $9,506.92 | $15,202.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,396.41 / $12,647.95 / $19,215.91
| Facility | | $7,396.41 | $12,647.95 | $19,215.91 |