- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,489.63 / $20,892.96
| Facility | | $9,549.93 | $13,489.63 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $11,481.54 / $15,848.93
| Facility | | $7,079.46 | $11,481.54 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $16,218.10 / $23,442.29
| Facility | | $14,791.08 | $16,218.10 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $15,135.61 / $20,892.96
| Facility | | $13,803.84 | $15,135.61 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,912.51 / $11,748.98
| Facility | | $5,623.41 | $8,912.51 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $14,454.40 / $20,417.38
| Facility | | $7,413.10 | $14,454.40 | $20,417.38 |