- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,475.40 / $13,876.20 / $24,278.10
| Facility | | $10,475.40 | $13,876.20 | $24,278.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,899.27 / $11,378.16 / $18,704.58
| Facility | | $7,899.27 | $11,378.16 | $18,704.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $12,489.69 / $24,164.34
| Facility | | $5,843.91 | $12,489.69 | $24,164.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,940.33 / $14,093.37 / $21,676.05
| Facility | | $9,940.33 | $14,093.37 | $21,676.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,300.06 / $21,841.58
| Facility | | $3,496.00 | $14,300.06 | $21,841.58 |