- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,934.81 / $13,160.00 / $23,025.10
| Facility | | $9,934.81 | $13,160.00 | $23,025.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,268.01 / $10,492.34 / $17,311.31
| Facility | | $6,268.01 | $10,492.34 | $17,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.47 / $11,096.27 / $22,196.18
| Facility | | $5,786.47 | $11,096.27 | $22,196.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,368.04 / $13,366.02 / $20,557.34
| Facility | | $9,368.04 | $13,366.02 | $20,557.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,557.93 / $20,714.33
| Facility | | $3,496.00 | $14,557.93 | $20,714.33 |