- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,883.40 / $15,272.30 / $23,281.50
| Facility | | $10,883.40 | $15,272.30 | $23,281.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,857.04 / $13,711.06 / $19,927.16
| Facility | | $8,857.04 | $13,711.06 | $19,927.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,494.34 / $13,317.47 / $23,724.00
| Facility | | $9,494.34 | $13,317.47 | $23,724.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.92 / $139.01 / $221.55
| Facility | | $100.92 | $139.01 | $221.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,457.54 / $14,472.83 / $23,818.90
| Facility | | $10,457.54 | $14,472.83 | $23,818.90 |