- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,639.37 / $12,768.70 / $22,340.40
| Facility | | $9,639.37 | $12,768.70 | $22,340.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,803.33 / $10,309.09 / $17,997.00
| Facility | | $7,803.33 | $10,309.09 | $17,997.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $12,125.65 / $22,291.33
| Facility | | $5,843.91 | $12,125.65 | $22,291.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,181.00 / $13,082.17 / $19,946.03
| Facility | | $9,181.00 | $13,082.17 | $19,946.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,158.74 / $20,098.34
| Facility | | $3,496.00 | $13,158.74 | $20,098.34 |