- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,952.62 / $30,902.95
| Facility | | $14,125.38 | $19,952.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,982.44 / $25,703.96
| Facility | | $11,748.98 | $16,982.44 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $21,379.62 / $31,622.78
| Facility | | $13,182.57 | $21,379.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $18,197.01 / $28,840.32
| Facility | | $11,481.54 | $18,197.01 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $13,182.57 / $21,877.62
| Facility | | $8,317.64 | $13,182.57 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $22,387.21 / $30,902.95
| Facility | | $9,120.11 | $22,387.21 | $30,902.95 |