- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $15,488.17 / $20,892.96
| Facility | | $6,025.60 | $15,488.17 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $19,498.45 / $31,622.78
| Facility | | $8,317.64 | $19,498.45 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,882.50 / $14,454.40
| Facility | | $9,332.54 | $12,882.50 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $16,218.10 / $22,908.68
| Facility | | $13,182.57 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $17,782.79 / $23,442.29
| Facility | | $2,041.74 | $17,782.79 | $23,442.29 |