- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $14,791.08 / $19,054.61
| Facility | | $12,589.25 | $14,791.08 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $15,488.17 / $26,302.68
| Facility | | $6,606.93 | $15,488.17 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $17,782.79 / $26,302.68
| Facility | | $13,489.63 | $17,782.79 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $16,218.10 / $26,915.35
| Facility | | $8,511.38 | $16,218.10 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,135.61 / $23,442.29
| Facility | | $9,549.93 | $15,135.61 | $23,442.29 |