- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,928.83 / $13,152.10 / $23,011.20
| Facility | | $9,928.83 | $13,152.10 | $23,011.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,492.61 / $10,352.95 / $14,815.00
| Facility | | $6,492.61 | $10,352.95 | $14,815.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,239.88 / $22,688.22
| Facility | | $5,843.91 | $11,239.88 | $22,688.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,421.64 / $13,357.97 / $20,544.98
| Facility | | $9,421.64 | $13,357.97 | $20,544.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,553.87 / $20,701.86
| Facility | | $3,496.00 | $13,553.87 | $20,701.86 |