- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,021.37 / $15,229.60 / $26,799.70
| Facility | | $9,021.37 | $15,229.60 | $26,799.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,649.25 / $11,291.04 / $18,542.25
| Facility | | $7,649.25 | $11,291.04 | $18,542.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,206.36 / $14,037.96 / $19,476.87
| Facility | | $8,206.36 | $14,037.96 | $19,476.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,001.60 / $29,001.60 / $34,035.83
| Facility | | $29,001.60 | $29,001.60 | $34,035.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $13,574.00 / $22,199.92
| Facility | | $3,158.00 | $13,574.00 | $22,199.92 |