- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,295.40 / $13,269.40 / $26,966.90
| Facility | | $10,295.40 | $13,269.40 | $26,966.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,735.59 / $11,352.47 / $14,979.16
| Facility | | $9,735.59 | $11,352.47 | $14,979.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,290.03 / $12,898.77 / $14,746.63
| Facility | | $10,290.03 | $12,898.77 | $14,746.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,217.92 / $14,546.59 / $18,918.47
| Facility | | $8,217.92 | $14,546.59 | $18,918.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,793.54 / $13,062.98 / $17,604.97
| Facility | | $10,793.54 | $13,062.98 | $17,604.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,857.00 / $14,935.93 / $20,460.04
| Facility | | $1,857.00 | $14,935.93 | $20,460.04 |