- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.95 / $13,019.20 / $20,962.59
| Facility | | $5,693.95 | $13,019.20 | $20,962.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,351.55 / $17,741.96
| Facility | | $1,474.01 | $6,351.55 | $17,741.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,424.25 / $13,612.44 / $19,283.66
| Facility | | $9,424.25 | $13,612.44 | $19,283.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,237.83 / $11,417.13 / $23,977.38
| Facility | | $8,237.83 | $11,417.13 | $23,977.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,734.46 / $11,417.13 / $24,286.97
| Facility | | $7,734.46 | $11,417.13 | $24,286.97 |