- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,984.86 / $12,654.30 / $21,009.10
| Facility | | $7,984.86 | $12,654.30 | $21,009.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,501.66 / $11,237.93 / $19,037.29
| Facility | | $7,501.66 | $11,237.93 | $19,037.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,907.58 / $13,497.24 / $19,407.39
| Facility | | $10,907.58 | $13,497.24 | $19,407.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,780.63 / $12,965.64 / $33,544.46
| Facility | | $6,780.63 | $12,965.64 | $33,544.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,780.63 / $12,937.43 / $18,182.91
| Facility | | $6,780.63 | $12,937.43 | $18,182.91 |