- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $11,748.98 / $18,197.01
| Facility | | $9,120.11 | $11,748.98 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,943.28 / $16,595.87
| Facility | | $5,495.41 | $7,943.28 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $7,244.36 / $12,589.25
| Facility | | $2,290.87 | $7,244.36 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $15,135.61 / $17,378.01
| Facility | | $10,471.29 | $15,135.61 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $9,549.93 / $14,125.38
| Facility | | $3,311.31 | $9,549.93 | $14,125.38 |