- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,412.40 / $10,809.80 / $17,547.59
| Facility | | $7,412.40 | $10,809.80 | $17,547.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,622.59 / $13,925.18 / $27,239.24
| Facility | | $11,622.59 | $13,925.18 | $27,239.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,484.83 / $19,170.70 / $24,577.82
| Facility | | $13,484.83 | $19,170.70 | $24,577.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,703.90 / $16,828.16 / $21,284.60
| Facility | | $8,703.90 | $16,828.16 | $21,284.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,733.60 / $11,625.10 / $18,589.09
| Facility | | $7,733.60 | $11,625.10 | $18,589.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.36 / $15,465.97 / $23,497.31
| Facility | | $9,044.36 | $15,465.97 | $23,497.31 |