- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,405.29 / $13,365.50 / $22,167.10
| Facility | | $10,405.29 | $13,365.50 | $22,167.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,271.50 / $11,870.58 / $16,563.24
| Facility | | $9,271.50 | $11,870.58 | $16,563.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,508.81 / $14,241.21 / $20,477.13
| Facility | | $11,508.81 | $14,241.21 | $20,477.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,154.38 / $13,680.31 / $18,940.21
| Facility | | $7,154.38 | $13,680.31 | $18,940.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,154.38 / $13,650.55 / $19,185.16
| Facility | | $7,154.38 | $13,650.55 | $19,185.16 |