- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,504.92 / $14,357.70 / $25,265.40
| Facility | | $8,504.92 | $14,357.70 | $25,265.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,123.68 / $5,872.55 / $9,714.82
| Facility | | $4,123.68 | $5,872.55 | $9,714.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,514.70 / $13,234.30 / $18,415.28
| Facility | | $7,514.70 | $13,234.30 | $18,415.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,027.35 / $27,027.35 / $31,718.89
| Facility | | $27,027.35 | $27,027.35 | $31,718.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,512.62 / $17,872.84
| Facility | | $1,787.00 | $12,512.62 | $17,872.84 |