- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,322.90 / $16,741.70 / $23,517.70
| Facility | | $12,322.90 | $16,741.70 | $23,517.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,751.14 / $15,280.65 / $22,327.37
| Facility | | $9,751.14 | $15,280.65 | $22,327.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,750.17 / $14,841.26 / $26,862.00
| Facility | | $10,750.17 | $14,841.26 | $26,862.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.27 / $157.40 / $250.85
| Facility | | $114.27 | $157.40 | $250.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,840.77 / $16,387.16 / $26,969.45
| Facility | | $11,840.77 | $16,387.16 | $26,969.45 |