- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,374.79 / $12,213.30 / $19,825.90
| Facility | | $8,374.79 | $12,213.30 | $19,825.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,123.50 / $23,264.67 / $25,542.66
| Facility | | $17,123.50 | $23,264.67 | $25,542.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,574.93 / $24,985.39 / $32,032.55
| Facility | | $17,574.93 | $24,985.39 | $32,032.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,833.98 / $19,013.09 / $24,048.11
| Facility | | $9,833.98 | $19,013.09 | $24,048.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,737.70 / $13,134.50 / $21,002.60
| Facility | | $8,737.70 | $13,134.50 | $21,002.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,218.65 / $17,474.02 / $26,548.12
| Facility | | $10,218.65 | $17,474.02 | $26,548.12 |