- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,521.87 / $14,108.20 / $25,478.40
| Facility | | $9,521.87 | $14,108.20 | $25,478.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,492.92 / $11,490.88 / $18,795.25
| Facility | | $8,492.92 | $11,490.88 | $18,795.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $12,951.96 / $25,058.71
| Facility | | $5,843.91 | $12,951.96 | $25,058.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,456.14 / $16,421.00 / $26,278.91
| Facility | | $10,456.14 | $16,421.00 | $26,278.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,586.08 / $25,718.00
| Facility | | $3,496.00 | $16,586.08 | $25,718.00 |