- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,868.20 / $10,016.10 / $16,259.30
| Facility | | $6,868.20 | $10,016.10 | $16,259.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,858.69 / $11,781.11 / $14,903.22
| Facility | | $10,858.69 | $11,781.11 | $14,903.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,719.04 / $22,346.96 / $28,649.95
| Facility | | $15,719.04 | $22,346.96 | $28,649.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,064.88 / $15,592.69 / $19,721.93
| Facility | | $8,064.88 | $15,592.69 | $19,721.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,165.82 / $10,771.60 / $17,224.30
| Facility | | $7,165.82 | $10,771.60 | $17,224.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,380.35 / $14,330.50 / $21,772.19
| Facility | | $8,380.35 | $14,330.50 | $21,772.19 |