- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,025.26 / $16,063.30 / $25,863.90
| Facility | | $7,025.26 | $16,063.30 | $25,863.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,707.78 / $14,395.52 / $21,131.83
| Facility | | $8,707.78 | $14,395.52 | $21,131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,859.13 / $21,805.30
| Facility | | $1,474.01 | $7,859.13 | $21,805.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,627.73 / $16,795.16 / $23,792.38
| Facility | | $11,627.73 | $16,795.16 | $23,792.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,163.92 / $14,086.57 / $29,583.54
| Facility | | $10,163.92 | $14,086.57 | $29,583.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,542.86 / $14,086.57 / $29,965.52
| Facility | | $9,542.86 | $14,086.57 | $29,965.52 |