- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,228.14 / $12,092.50 / $18,669.70
| Facility | | $8,228.14 | $12,092.50 | $18,669.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.25 / $15,207.15 / $37,435.86
| Facility | | $13,531.25 | $15,207.15 | $37,435.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,471.64 / $17,730.30 / $22,731.15
| Facility | | $12,471.64 | $17,730.30 | $22,731.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,260.49 / $17,904.28 / $22,645.68
| Facility | | $9,260.49 | $17,904.28 | $22,645.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,228.14 / $12,368.50 / $19,777.80
| Facility | | $8,228.14 | $12,368.50 | $19,777.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,622.71 / $16,454.97 / $24,999.89
| Facility | | $9,622.71 | $16,454.97 | $24,999.89 |