- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,221.61 / $14,830.80 / $24,622.60
| Facility | | $11,221.61 | $14,830.80 | $24,622.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,657.58 / $13,253.38 / $21,970.72
| Facility | | $8,657.58 | $13,253.38 | $21,970.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,783.66 / $15,818.73 / $23,020.00
| Facility | | $12,783.66 | $15,818.73 | $23,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,946.88 / $15,881.04 / $38,713.28
| Facility | | $7,946.88 | $15,881.04 | $38,713.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,946.88 / $15,162.64 / $21,310.34
| Facility | | $7,946.88 | $15,162.64 | $21,310.34 |