- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,380.60 / $17,219.70 / $23,107.50
| Facility | | $10,380.60 | $17,219.70 | $23,107.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,841.04 / $9,841.04 / $11,753.17
| Facility | | $9,841.04 | $9,841.04 | $11,753.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,129.37 / $13,890.54 / $22,059.98
| Facility | | $8,129.37 | $13,890.54 | $22,059.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,523.89 / $13,864.50 / $31,796.84
| Facility | | $8,523.89 | $13,864.50 | $31,796.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,060.08 / $13,657.46 / $19,347.45
| Facility | | $10,060.08 | $13,657.46 | $19,347.45 |