- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.09 / $16,047.90 / $28,239.60
| Facility | | $9,506.09 | $16,047.90 | $28,239.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,318.42 / $9,272.66 / $15,191.17
| Facility | | $6,318.42 | $9,272.66 | $15,191.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,647.28 / $14,792.20 / $20,425.37
| Facility | | $8,647.28 | $14,792.20 | $20,425.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,157.20 / $27,157.20 / $31,871.28
| Facility | | $27,157.20 | $27,157.20 | $31,871.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $13,985.56 / $19,976.78
| Facility | | $1,787.00 | $13,985.56 | $19,976.78 |