- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,574.83 / $11,051.80 / $22,460.20
| Facility | | $8,574.83 | $11,051.80 | $22,460.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,959.81 / $9,977.79 / $11,407.19
| Facility | | $7,959.81 | $9,977.79 | $11,407.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,844.55 / $12,115.58 / $15,756.83
| Facility | | $6,844.55 | $12,115.58 | $15,756.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,794.83 / $8,794.83 / $8,794.83
| Facility | | $8,794.83 | $8,794.83 | $8,794.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $9,716.39 / $14,963.48
| Facility | | $1,286.00 | $9,716.39 | $14,963.48 |