- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,232.93 / $22,908.68
| Facility | | $8,912.51 | $10,232.93 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,882.50 / $16,982.44
| Facility | | $9,772.37 | $12,882.50 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,481.54 / $14,125.38
| Facility | | $7,585.78 | $11,481.54 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,182.57 / $25,118.86
| Facility | | $8,128.31 | $13,182.57 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $10,232.93 / $16,218.10
| Facility | | $3,801.89 | $10,232.93 | $16,218.10 |