- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,066.51 / $15,305.80 / $26,933.70
| Facility | | $9,066.51 | $15,305.80 | $26,933.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,353.42 / $10,765.72 / $17,852.24
| Facility | | $7,353.42 | $10,765.72 | $17,852.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,010.90 / $14,108.18 / $19,555.59
| Facility | | $8,010.90 | $14,108.18 | $19,555.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,582.90 / $28,582.90 / $33,544.46
| Facility | | $28,582.90 | $28,582.90 | $33,544.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,338.85 / $19,053.00
| Facility | | $1,787.00 | $13,338.85 | $19,053.00 |