- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,845.30 / $13,161.40 / $13,161.40
| Facility | | $11,845.30 | $13,161.40 | $13,161.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,492.56 / $11,823.53 / $21,064.07
| Facility | | $6,492.56 | $11,823.53 | $21,064.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,620.03 / $10,029.28 / $18,425.93
| Facility | | $5,620.03 | $10,029.28 | $18,425.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,213.98 / $14,491.12 / $22,773.82
| Facility | | $8,213.98 | $14,491.12 | $22,773.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $19,662.80 / $25,387.97
| Facility | | $6,965.00 | $19,662.80 | $25,387.97 |