- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,861.90 / $17,213.70 / $28,578.90
| Facility | | $10,861.90 | $17,213.70 | $28,578.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,968.46 / $13,435.30 / $22,759.67
| Facility | | $8,968.46 | $13,435.30 | $22,759.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,837.69 / $18,360.43 / $26,400.05
| Facility | | $14,837.69 | $18,360.43 | $26,400.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,871.03 / $17,637.29 / $40,103.44
| Facility | | $8,871.03 | $17,637.29 | $40,103.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,223.75 / $17,598.91 / $24,734.41
| Facility | | $9,223.75 | $17,598.91 | $24,734.41 |