- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,659.92 / $13,451.60 / $23,535.10
| Facility | | $9,659.92 | $13,451.60 | $23,535.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,186.69 / $9,526.96 / $19,318.09
| Facility | | $8,186.69 | $9,526.96 | $19,318.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,377.00 / $11,987.90 / $23,411.33
| Facility | | $5,377.00 | $11,987.90 | $23,411.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,636.15 / $13,662.11 / $21,012.75
| Facility | | $9,636.15 | $13,662.11 | $21,012.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $15,321.05 / $22,501.00
| Facility | | $3,496.00 | $15,321.05 | $22,501.00 |