- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $19,952.62
| Facility | | $9,549.93 | $13,182.57 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,748.98 / $17,782.79
| Facility | | $7,413.10 | $11,748.98 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,481.54 / $20,417.38
| Facility | | $8,128.31 | $11,481.54 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $128.82 / $194.98
| Facility | | $91.20 | $128.82 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,882.50 / $18,620.87
| Facility | | $8,511.38 | $12,882.50 | $18,620.87 |