- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $16,982.44 / $25,703.96
| Facility | | $13,182.57 | $16,982.44 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $16,218.10 / $24,547.09
| Facility | | $6,456.54 | $16,218.10 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,489.63 / $25,118.86
| Facility | | $9,772.37 | $13,489.63 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $11,481.54 / $20,417.38
| Facility | | $3,311.31 | $11,481.54 | $20,417.38 |