- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,551.83 / $17,496.70 / $24,773.40
| Facility | | $9,551.83 | $17,496.70 | $24,773.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,014.97 / $17,717.63 / $28,312.61
| Facility | | $11,014.97 | $17,717.63 | $28,312.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,931.02 / $15,739.16 / $28,002.47
| Facility | | $9,931.02 | $15,739.16 | $28,002.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,319.74 / $14,849.88 / $33,112.97
| Facility | | $6,319.74 | $14,849.88 | $33,112.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,526.37 / $29,425.91
| Facility | | $3,308.00 | $14,526.37 | $29,425.91 |