- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,377.83 / $12,234.10 / $16,079.90
| Facility | | $8,377.83 | $12,234.10 | $16,079.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,752.44 / $8,901.17 / $10,587.30
| Facility | | $6,752.44 | $8,901.17 | $10,587.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,691.42 / $10,053.14 / $17,003.53
| Facility | | $3,691.42 | $10,053.14 | $17,003.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,510.73 / $12,288.50 / $20,568.16
| Facility | | $8,510.73 | $12,288.50 | $20,568.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,538.18 / $13,714.13 / $20,023.74
| Facility | | $10,538.18 | $13,714.13 | $20,023.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,538.18 / $12,749.11 / $20,023.74
| Facility | | $10,538.18 | $12,749.11 | $20,023.74 |