- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,943.68 / $13,060.40 / $17,165.90
| Facility | | $8,943.68 | $13,060.40 | $17,165.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,503.46 / $13,193.78 / $23,197.62
| Facility | | $4,503.46 | $13,193.78 | $23,197.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,085.54 / $13,118.47 / $21,957.36
| Facility | | $9,085.54 | $13,118.47 | $21,957.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,249.93 / $14,640.39 / $21,376.16
| Facility | | $11,249.93 | $14,640.39 | $21,376.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,459.65 / $12,501.80 / $19,957.41
| Facility | | $7,459.65 | $12,501.80 | $19,957.41 |