- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,962.37 / $11,871.90 / $20,771.30
| Facility | | $8,962.37 | $11,871.90 | $20,771.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,040.68 / $9,730.41 / $9,839.89
| Facility | | $6,040.68 | $9,730.41 | $9,839.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $10,611.59 / $20,336.75
| Facility | | $5,843.91 | $10,611.59 | $20,336.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,596.71 / $12,649.00 / $18,545.18
| Facility | | $8,596.71 | $12,649.00 | $18,545.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $12,234.57 / $18,686.79
| Facility | | $3,496.00 | $12,234.57 | $18,686.79 |