- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,199.70 / $11,857.20 / $24,096.90
| Facility | | $9,199.70 | $11,857.20 | $24,096.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,161.77 / $12,094.19 / $15,726.52
| Facility | | $10,161.77 | $12,094.19 | $15,726.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,115.69 / $11,426.71 / $13,063.68
| Facility | | $9,115.69 | $11,426.71 | $13,063.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,343.34 / $12,998.48 / $16,905.08
| Facility | | $7,343.34 | $12,998.48 | $16,905.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,760.10 / $13,908.32 / $18,085.50
| Facility | | $11,760.10 | $13,908.32 | $18,085.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $10,424.45 / $16,053.92
| Facility | | $1,286.00 | $10,424.45 | $16,053.92 |