- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,810.74 / $15,039.60 / $24,445.60
| Facility | | $8,810.74 | $15,039.60 | $24,445.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,967.04 / $13,884.57 / $17,462.02
| Facility | | $10,967.04 | $13,884.57 | $17,462.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,555.15 / $11,949.70 / $18,851.80
| Facility | | $7,555.15 | $11,949.70 | $18,851.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,939.11 / $8,509.83 / $19,012.72
| Facility | | $3,939.11 | $8,509.83 | $19,012.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $12,655.42 / $17,187.07
| Facility | | $6,164.00 | $12,655.42 | $17,187.07 |