- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,416.79 / $13,798.50 / $24,142.20
| Facility | | $10,416.79 | $13,798.50 | $24,142.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,996.49 / $11,297.75 / $18,321.34
| Facility | | $8,996.49 | $11,297.75 | $18,321.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $12,164.96 / $23,944.15
| Facility | | $5,843.91 | $12,164.96 | $23,944.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,884.71 / $14,014.52 / $21,554.78
| Facility | | $9,884.71 | $14,014.52 | $21,554.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,220.06 / $21,719.38
| Facility | | $3,496.00 | $14,220.06 | $21,719.38 |