- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,058.15 / $14,760.60 / $20,899.40
| Facility | | $8,058.15 | $14,760.60 | $20,899.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,281.86 / $13,354.11 / $21,287.50
| Facility | | $8,281.86 | $13,354.11 | $21,287.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,378.04 / $13,277.92 / $23,623.53
| Facility | | $8,378.04 | $13,277.92 | $23,623.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,331.48 / $12,462.31 / $27,934.87
| Facility | | $5,331.48 | $12,462.31 | $27,934.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,254.79 / $24,824.39
| Facility | | $3,308.00 | $12,254.79 | $24,824.39 |