- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,374.84 / $16,002.50 / $26,010.80
| Facility | | $9,374.84 | $16,002.50 | $26,010.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,958.77 / $17,834.41 / $20,266.00
| Facility | | $9,958.77 | $17,834.41 | $20,266.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,038.87 / $12,714.77 / $20,058.78
| Facility | | $8,038.87 | $12,714.77 | $20,058.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,772.76 / $10,198.69 / $20,229.99
| Facility | | $4,772.76 | $10,198.69 | $20,229.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $13,465.68 / $18,287.46
| Facility | | $6,289.00 | $13,465.68 | $18,287.46 |