- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,239.41 / $14,266.40 / $22,970.80
| Facility | | $6,239.41 | $14,266.40 | $22,970.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $9,677.46 / $21,852.52
| Facility | | $1,474.01 | $9,677.46 | $21,852.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,327.06 / $14,916.47 / $21,130.97
| Facility | | $10,327.06 | $14,916.47 | $21,130.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,026.98 / $12,510.85 / $26,274.33
| Facility | | $9,026.98 | $12,510.85 | $26,274.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,475.40 / $12,510.85 / $26,613.58
| Facility | | $8,475.40 | $12,510.85 | $26,613.58 |