- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,190.19 / $15,514.60 / $27,301.20
| Facility | | $9,190.19 | $15,514.60 | $27,301.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,669.65 / $9,443.94 / $15,390.89
| Facility | | $6,669.65 | $9,443.94 | $15,390.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,359.92 / $14,300.64 / $19,771.33
| Facility | | $8,359.92 | $14,300.64 | $19,771.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,344.40 / $28,344.40 / $33,264.56
| Facility | | $28,344.40 | $28,344.40 | $33,264.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,520.81 / $19,312.93
| Facility | | $1,787.00 | $13,520.81 | $19,312.93 |