- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,678.17 / $12,983.10 / $20,904.50
| Facility | | $5,678.17 | $12,983.10 | $20,904.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,703.54 / $17,062.23
| Facility | | $1,474.01 | $6,703.54 | $17,062.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,398.12 / $13,574.71 / $19,230.21
| Facility | | $9,398.12 | $13,574.71 | $19,230.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,215.00 / $11,385.49 / $23,910.93
| Facility | | $8,215.00 | $11,385.49 | $23,910.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,783.89 / $13,835.95 / $20,526.68
| Facility | | $8,783.89 | $13,835.95 | $20,526.68 |