- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,711.10 / $14,188.30 / $24,824.20
| Facility | | $10,711.10 | $14,188.30 | $24,824.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,688.99 / $10,807.43 / $24,009.61
| Facility | | $6,688.99 | $10,807.43 | $24,009.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,885.28 / $24,297.55
| Facility | | $5,843.91 | $11,885.28 | $24,297.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,163.93 / $14,410.39 / $22,163.63
| Facility | | $10,163.93 | $14,410.39 | $22,163.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,621.72 / $22,332.87
| Facility | | $3,496.00 | $14,621.72 | $22,332.87 |