- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,759.29 / $16,475.30 / $28,991.80
| Facility | | $9,759.29 | $16,475.30 | $28,991.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,021.74 / $11,840.88 / $19,445.21
| Facility | | $8,021.74 | $11,840.88 | $19,445.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,877.62 / $15,186.22 / $20,969.45
| Facility | | $8,877.62 | $15,186.22 | $20,969.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,218.90 / $29,218.90 / $34,290.86
| Facility | | $29,218.90 | $29,218.90 | $34,290.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,358.10 / $20,508.90
| Facility | | $1,787.00 | $14,358.10 | $20,508.90 |