- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $10,715.19 / $20,417.38
| Facility | | $2,754.23 | $10,715.19 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,378.01 / $21,379.62
| Facility | | $11,481.54 | $17,378.01 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,791.08 / $19,054.61
| Facility | | $9,332.54 | $14,791.08 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $12,882.50 / $32,359.37
| Facility | | $7,244.36 | $12,882.50 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,022.64 / $18,197.01
| Facility | | $4,365.16 | $12,022.64 | $18,197.01 |