- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,885.21 / $15,665.90 / $26,009.10
| Facility | | $9,885.21 | $15,665.90 | $26,009.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,567.86 / $12,835.16 / $21,743.03
| Facility | | $8,567.86 | $12,835.16 | $21,743.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,979.00 / $16,709.50 / $23,925.98
| Facility | | $12,979.00 | $16,709.50 | $23,925.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,394.37 / $16,051.39 / $38,312.08
| Facility | | $8,394.37 | $16,051.39 | $38,312.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,394.37 / $16,016.47 / $22,510.36
| Facility | | $8,394.37 | $16,016.47 | $22,510.36 |