- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,524.54 / $12,616.60 / $22,074.20
| Facility | | $9,524.54 | $12,616.60 | $22,074.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,054.33 / $10,142.79 / $14,788.83
| Facility | | $6,054.33 | $10,142.79 | $14,788.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $10,987.05 / $21,456.76
| Facility | | $5,843.91 | $10,987.05 | $21,456.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,086.98 / $12,926.34 / $19,708.43
| Facility | | $9,086.98 | $12,926.34 | $19,708.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,001.99 / $19,858.93
| Facility | | $3,496.00 | $13,001.99 | $19,858.93 |