- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,702.80 / $11,233.30 / $18,235.09
| Facility | | $7,702.80 | $11,233.30 | $18,235.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,434.70 / $16,300.20 / $24,407.84
| Facility | | $12,434.70 | $16,300.20 | $24,407.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,603.56 / $20,761.14 / $26,616.84
| Facility | | $14,603.56 | $20,761.14 | $26,616.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.90 / $17,487.46 / $22,118.47
| Facility | | $9,044.90 | $17,487.46 | $22,118.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,036.59 / $12,080.60 / $19,317.30
| Facility | | $8,036.59 | $12,080.60 | $19,317.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,398.70 / $16,071.89 / $24,417.88
| Facility | | $9,398.70 | $16,071.89 | $24,417.88 |