- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $14,791.08 / $22,387.21
| Facility | | $11,481.54 | $14,791.08 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $11,748.98 / $14,791.08
| Facility | | $9,772.37 | $11,748.98 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $14,125.38 / $21,379.62
| Facility | | $6,918.31 | $14,125.38 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $11,748.98 / $21,877.62
| Facility | | $8,511.38 | $11,748.98 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $10,471.29 / $17,782.79
| Facility | | $3,311.31 | $10,471.29 | $17,782.79 |