- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,007.17 / $15,205.60 / $26,757.50
| Facility | | $9,007.17 | $15,205.60 | $26,757.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,900.13 / $7,233.08 / $11,878.23
| Facility | | $4,900.13 | $7,233.08 | $11,878.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,958.48 / $14,015.85 / $19,452.09
| Facility | | $7,958.48 | $14,015.85 | $19,452.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,547.70 / $26,547.70 / $31,155.98
| Facility | | $26,547.70 | $26,547.70 | $31,155.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,251.55 / $18,928.32
| Facility | | $1,787.00 | $13,251.55 | $18,928.32 |