- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,483.69 / $12,633.70 / $22,231.70
| Facility | | $7,483.69 | $12,633.70 | $22,231.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,381.68 / $10,922.25 / $18,068.41
| Facility | | $7,381.68 | $10,922.25 | $18,068.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,807.59 / $11,645.20 / $16,465.36
| Facility | | $6,807.59 | $11,645.20 | $16,465.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,685.70 / $23,685.70 / $27,797.18
| Facility | | $23,685.70 | $23,685.70 | $27,797.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $11,010.17 / $15,726.77
| Facility | | $1,787.00 | $11,010.17 | $15,726.77 |