- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,047.50 / $13,148.40 / $23,054.20
| Facility | | $2,047.50 | $13,148.40 | $23,054.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.39 / $9,044.39 / $17,454.30
| Facility | | $9,044.39 | $9,044.39 | $17,454.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,874.21 / $11,427.28 / $16,216.62
| Facility | | $5,874.21 | $11,427.28 | $16,216.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,575.24 / $11,488.29 / $20,129.02
| Facility | | $8,575.24 | $11,488.29 | $20,129.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,420.19 / $13,010.60 / $17,434.59
| Facility | | $8,420.19 | $13,010.60 | $17,434.59 |