- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $17,378.01 / $26,302.68
| Facility | | $12,589.25 | $17,378.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $13,489.63 / $19,054.61
| Facility | | $6,606.93 | $13,489.63 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,488.17 / $22,387.21
| Facility | | $9,549.93 | $15,488.17 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $26,915.35
| Facility | | $10,715.19 | $15,135.61 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $169.82 / $251.19
| Facility | | $114.82 | $169.82 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,595.87 / $24,547.09
| Facility | | $10,964.78 | $16,595.87 | $24,547.09 |