- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,746.44 / $14,765.40 / $25,982.90
| Facility | | $8,746.44 | $14,765.40 | $25,982.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,708.08 / $8,497.49 / $14,173.59
| Facility | | $5,708.08 | $8,497.49 | $14,173.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,956.25 / $13,610.12 / $18,938.23
| Facility | | $7,956.25 | $13,610.12 | $18,938.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,222.70 / $25,222.70 / $29,600.98
| Facility | | $25,222.70 | $25,222.70 | $29,600.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,158.00 / $13,569.17 / $21,523.33
| Facility | | $3,158.00 | $13,569.17 | $21,523.33 |