- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,981.40 / $13,115.50 / $17,238.30
| Facility | | $8,981.40 | $13,115.50 | $17,238.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,332.15 / $9,621.86 / $18,790.55
| Facility | | $7,332.15 | $9,621.86 | $18,790.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,110.75 / $11,195.13 / $18,935.06
| Facility | | $4,110.75 | $11,195.13 | $18,935.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,123.87 / $13,173.80 / $22,049.97
| Facility | | $9,123.87 | $13,173.80 | $22,049.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,297.38 / $14,702.14 / $21,466.32
| Facility | | $11,297.38 | $14,702.14 | $21,466.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,297.38 / $13,667.60 / $21,466.32
| Facility | | $11,297.38 | $13,667.60 | $21,466.32 |