- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,641.50 / $16,293.20 / $33,112.19
| Facility | | $12,641.50 | $16,293.20 | $33,112.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,596.11 / $15,789.49 / $18,051.47
| Facility | | $12,596.11 | $15,789.49 | $18,051.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,090.65 / $17,861.50 / $23,229.67
| Facility | | $10,090.65 | $17,861.50 | $23,229.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,733.14 / $9,733.14 / $9,733.14
| Facility | | $9,733.14 | $9,733.14 | $9,733.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $14,324.49 / $22,060.07
| Facility | | $1,286.00 | $14,324.49 | $22,060.07 |