- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $16,982.44 / $25,703.96
| Facility | | $12,302.69 | $16,982.44 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,135.61 / $22,387.21
| Facility | | $9,549.93 | $15,135.61 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,791.08 / $26,302.68
| Facility | | $10,471.29 | $14,791.08 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $165.96 / $251.19
| Facility | | $112.20 | $165.96 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,595.87 / $24,547.09
| Facility | | $10,964.78 | $16,595.87 | $24,547.09 |