- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,086.20 / $15,061.50 / $23,715.30
| Facility | | $11,086.20 | $15,061.50 | $23,715.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,021.34 / $13,949.18 / $20,296.81
| Facility | | $9,021.34 | $13,949.18 | $20,296.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,314.78 / $13,291.30 / $23,984.76
| Facility | | $9,314.78 | $13,291.30 | $23,984.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.98 / $134.97 / $215.10
| Facility | | $97.98 | $134.97 | $215.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,107.43 / $14,205.98 / $22,932.33
| Facility | | $10,107.43 | $14,205.98 | $22,932.33 |