- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,414.28 / $11,610.40 / $19,431.59
| Facility | | $8,414.28 | $11,610.40 | $19,431.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,422.37 / $14,506.95 / $16,931.75
| Facility | | $12,422.37 | $14,506.95 | $16,931.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $13,339.44 / $20,168.53
| Facility | | $2,423.00 | $13,339.44 | $20,168.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,611.95 / $13,062.17 / $21,905.18
| Facility | | $8,611.95 | $13,062.17 | $21,905.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $10,541.89 / $23,441.12
| Facility | | $2,600.00 | $10,541.89 | $23,441.12 |