- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $14,791.08 / $22,908.68
| Facility | | $11,748.98 | $14,791.08 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $7,943.28 / $14,125.38
| Facility | | $6,025.60 | $7,943.28 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $14,454.40 / $21,877.62
| Facility | | $6,309.57 | $14,454.40 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,589.25 / $20,892.96
| Facility | | $9,120.11 | $12,589.25 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $12,022.64 / $19,498.45
| Facility | | $3,467.37 | $12,022.64 | $19,498.45 |