- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,881.54 / $12,969.70 / $17,046.59
| Facility | | $8,881.54 | $12,969.70 | $17,046.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,815.53 / $7,815.53 / $8,001.70
| Facility | | $7,815.53 | $7,815.53 | $8,001.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,284.29 / $9,017.18 / $15,128.17
| Facility | | $3,284.29 | $9,017.18 | $15,128.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,022.44 / $13,027.34 / $21,804.82
| Facility | | $9,022.44 | $13,027.34 | $21,804.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,171.78 / $14,538.68 / $21,227.66
| Facility | | $11,171.78 | $14,538.68 | $21,227.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,171.78 / $13,515.64 / $21,227.66
| Facility | | $11,171.78 | $13,515.64 | $21,227.66 |