- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,031.75 / $11,963.80 / $20,932.09
| Facility | | $9,031.75 | $11,963.80 | $20,932.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,773.67 / $9,573.41 / $12,950.05
| Facility | | $6,773.67 | $9,573.41 | $12,950.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.47 / $10,449.74 / $20,407.43
| Facility | | $5,786.47 | $10,449.74 | $20,407.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,663.26 / $12,649.00 / $18,688.73
| Facility | | $8,663.26 | $12,649.00 | $18,688.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $12,329.27 / $18,831.43
| Facility | | $3,496.00 | $12,329.27 | $18,831.43 |