- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,803.84 / $31,622.78
| Facility | | $9,772.37 | $13,803.84 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $15,848.93 / $23,988.33
| Facility | | $13,182.57 | $15,848.93 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $11,481.54 / $19,952.62
| Facility | | $5,754.40 | $11,481.54 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $16,218.10 / $20,892.96
| Facility | | $11,481.54 | $16,218.10 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $21,379.62 / $33,113.11
| Facility | | $6,918.31 | $21,379.62 | $33,113.11 |