- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,609.80 / $11,097.60 / $18,014.90
| Facility | | $7,609.80 | $11,097.60 | $18,014.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,425.59 / $15,603.11 / $18,477.75
| Facility | | $13,425.59 | $15,603.11 | $18,477.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,981.68 / $19,877.04 / $25,483.39
| Facility | | $13,981.68 | $19,877.04 | $25,483.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,935.69 / $17,276.33 / $21,851.43
| Facility | | $8,935.69 | $17,276.33 | $21,851.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,939.56 / $11,934.70 / $19,084.09
| Facility | | $7,939.56 | $11,934.70 | $19,084.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,285.21 / $15,877.85 / $24,123.07
| Facility | | $9,285.21 | $15,877.85 | $24,123.07 |