- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,657.31 / $12,792.40 / $22,381.90
| Facility | | $9,657.31 | $12,792.40 | $22,381.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,166.90 / $10,109.68 / $15,731.27
| Facility | | $6,166.90 | $10,109.68 | $15,731.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,169.51 / $22,046.67
| Facility | | $5,843.91 | $11,169.51 | $22,046.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,181.00 / $13,106.52 / $19,983.15
| Facility | | $9,181.00 | $13,106.52 | $19,983.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,183.23 / $20,135.75
| Facility | | $3,496.00 | $13,183.23 | $20,135.75 |