- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $12,022.64 / $16,218.10
| Facility | | $11,481.54 | $12,022.64 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $13,489.63 / $23,442.29
| Facility | | $2,818.38 | $13,489.63 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,135.61 / $23,988.33
| Facility | | $10,964.78 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $13,803.84 / $23,442.29
| Facility | | $7,244.36 | $13,803.84 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,182.57 / $19,952.62
| Facility | | $8,912.51 | $13,182.57 | $19,952.62 |