- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,673.91 / $15,888.50 / $22,496.40
| Facility | | $8,673.91 | $15,888.50 | $22,496.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,298.62 / $14,918.31 / $23,447.21
| Facility | | $9,298.62 | $14,918.31 | $23,447.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,018.24 / $14,292.54 / $25,428.70
| Facility | | $9,018.24 | $14,292.54 | $25,428.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,738.88 / $13,485.00 / $30,069.49
| Facility | | $5,738.88 | $13,485.00 | $30,069.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,191.23 / $26,721.32
| Facility | | $3,308.00 | $13,191.23 | $26,721.32 |