- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,207.20 / $18,590.90 / $24,947.50
| Facility | | $11,207.20 | $18,590.90 | $24,947.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,255.98 / $11,575.40 / $30,219.55
| Facility | | $8,255.98 | $11,575.40 | $30,219.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,914.10 / $15,612.43 / $24,980.50
| Facility | | $8,914.10 | $15,612.43 | $24,980.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,202.62 / $14,968.50 / $34,328.76
| Facility | | $9,202.62 | $14,968.50 | $34,328.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,947.91 / $14,484.52 / $20,713.41
| Facility | | $10,947.91 | $14,484.52 | $20,713.41 |