- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,568.76 / $12,733.00 / $20,501.70
| Facility | | $5,568.76 | $12,733.00 | $20,501.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,236.16 / $6,433.27 / $18,066.91
| Facility | | $1,236.16 | $6,433.27 | $18,066.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,217.04 / $13,313.15 / $18,859.68
| Facility | | $9,217.04 | $13,313.15 | $18,859.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,056.71 / $11,166.11 / $23,450.21
| Facility | | $8,056.71 | $11,166.11 | $23,450.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,564.41 / $11,166.11 / $23,752.99
| Facility | | $7,564.41 | $11,166.11 | $23,752.99 |