- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $15,135.61 / $23,442.29
| Facility | | $11,748.98 | $15,135.61 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $14,791.08 / $16,982.44
| Facility | | $14,791.08 | $14,791.08 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $14,454.40 / $22,387.21
| Facility | | $6,606.93 | $14,454.40 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,022.64 / $22,387.21
| Facility | | $8,709.64 | $12,022.64 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $10,715.19 / $18,197.01
| Facility | | $3,311.31 | $10,715.19 | $18,197.01 |