- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,390.79 / $14,275.40 / $21,762.10
| Facility | | $8,390.79 | $14,275.40 | $21,762.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,234.33 / $14,757.86 / $23,233.01
| Facility | | $9,234.33 | $14,757.86 | $23,233.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,723.87 / $13,826.03 / $24,598.70
| Facility | | $8,723.87 | $13,826.03 | $24,598.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,551.56 / $13,195.70 / $29,088.01
| Facility | | $5,551.56 | $13,195.70 | $29,088.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,760.66 / $25,849.12
| Facility | | $3,308.00 | $12,760.66 | $25,849.12 |