- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,992.27 / $11,414.80 / $18,379.30
| Facility | | $4,992.27 | $11,414.80 | $18,379.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $8,720.96 / $16,926.46
| Facility | | $1,474.01 | $8,720.96 | $16,926.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,262.86 / $11,934.93 / $16,907.27
| Facility | | $8,262.86 | $11,934.93 | $16,907.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,222.65 / $10,010.16 / $21,022.57
| Facility | | $7,222.65 | $10,010.16 | $21,022.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,781.32 / $10,010.16 / $21,294.01
| Facility | | $6,781.32 | $10,010.16 | $21,294.01 |