- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,915.50 / $14,829.60 / $20,831.59
| Facility | | $10,915.50 | $14,829.60 | $20,831.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,715.15 / $13,741.33 / $19,857.53
| Facility | | $8,715.15 | $13,741.33 | $19,857.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,522.36 / $13,146.19 / $23,794.00
| Facility | | $9,522.36 | $13,146.19 | $23,794.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.22 / $139.41 / $222.20
| Facility | | $101.22 | $139.41 | $222.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,488.40 / $14,515.53 / $23,889.18
| Facility | | $10,488.40 | $14,515.53 | $23,889.18 |