- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,246.60 / $13,920.90 / $21,919.40
| Facility | | $10,246.60 | $13,920.90 | $21,919.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,341.75 / $12,949.43 / $19,237.93
| Facility | | $8,341.75 | $12,949.43 | $19,237.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,889.73 / $12,284.80 / $22,168.48
| Facility | | $8,889.73 | $12,284.80 | $22,168.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.02 / $130.88 / $208.58
| Facility | | $95.02 | $130.88 | $208.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,845.70 / $13,626.08 / $22,425.34
| Facility | | $9,845.70 | $13,626.08 | $22,425.34 |