- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,762.83 / $12,796.30 / $16,818.80
| Facility | | $8,762.83 | $12,796.30 | $16,818.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,407.37 / $10,311.67 / $10,822.56
| Facility | | $7,407.37 | $10,311.67 | $10,822.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,263.68 / $14,334.98 / $24,245.69
| Facility | | $5,263.68 | $14,334.98 | $24,245.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,901.84 / $12,853.21 / $21,513.36
| Facility | | $8,901.84 | $12,853.21 | $21,513.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,022.45 / $14,344.35 / $20,943.91
| Facility | | $11,022.45 | $14,344.35 | $20,943.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,022.45 / $13,334.98 / $20,943.91
| Facility | | $11,022.45 | $13,334.98 | $20,943.91 |