- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,062.79 / $13,329.60 / $23,321.70
| Facility | | $10,062.79 | $13,329.60 | $23,321.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,563.45 / $12,842.22 / $19,557.07
| Facility | | $12,563.45 | $12,842.22 | $19,557.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.47 / $11,883.57 / $25,412.11
| Facility | | $5,786.47 | $11,883.57 | $25,412.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,548.76 / $13,538.20 / $20,822.18
| Facility | | $9,548.76 | $13,538.20 | $20,822.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,736.75 / $20,981.18
| Facility | | $3,496.00 | $13,736.75 | $20,981.18 |