- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,020.90 / $13,614.30 / $19,124.40
| Facility | | $10,020.90 | $13,614.30 | $19,124.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,997.43 / $12,659.61 / $18,792.84
| Facility | | $7,997.43 | $12,659.61 | $18,792.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,741.96 / $12,068.81 / $21,680.17
| Facility | | $8,741.96 | $12,068.81 | $21,680.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.92 / $127.99 / $203.99
| Facility | | $92.92 | $127.99 | $203.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,136.25 / $12,841.00 / $20,728.86
| Facility | | $9,136.25 | $12,841.00 | $20,728.86 |