- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,014.53 / $10,153.50 / $17,867.30
| Facility | | $6,014.53 | $10,153.50 | $17,867.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,925.31 / $13,098.43 / $21,668.39
| Facility | | $8,925.31 | $13,098.43 | $21,668.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,471.16 / $9,359.07 / $13,472.78
| Facility | | $5,471.16 | $9,359.07 | $13,472.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,905.09 / $18,905.09 / $22,186.74
| Facility | | $18,905.09 | $18,905.09 | $22,186.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $9,654.78 / $16,112.00
| Facility | | $2,520.00 | $9,654.78 | $16,112.00 |