- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,051.17 / $14,747.80 / $20,881.30
| Facility | | $8,051.17 | $14,747.80 | $20,881.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,712.93 / $14,014.78 / $22,395.49
| Facility | | $8,712.93 | $14,014.78 | $22,395.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,370.78 / $13,266.42 / $23,603.06
| Facility | | $8,370.78 | $13,266.42 | $23,603.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,326.86 / $12,592.02 / $27,910.67
| Facility | | $5,326.86 | $12,592.02 | $27,910.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,244.17 / $24,802.87
| Facility | | $3,308.00 | $12,244.17 | $24,802.87 |