- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,538.37 / $13,928.90 / $18,307.30
| Facility | | $9,538.37 | $13,928.90 | $18,307.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,605.15 / $15,264.93 / $25,818.57
| Facility | | $5,605.15 | $15,264.93 | $25,818.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,039.58 / $14,055.24 / $25,070.57
| Facility | | $10,039.58 | $14,055.24 | $25,070.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,997.97 / $15,613.87 / $22,797.52
| Facility | | $11,997.97 | $15,613.87 | $22,797.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,997.97 / $14,515.17 / $22,797.52
| Facility | | $11,997.97 | $14,515.17 | $22,797.52 |