- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,748.18 / $15,548.10 / $27,380.30
| Facility | | $9,748.18 | $15,548.10 | $27,380.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,650.43 / $12,806.29 / $18,227.71
| Facility | | $6,650.43 | $12,806.29 | $18,227.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,013.77 / $12,089.50 / $20,252.74
| Facility | | $9,013.77 | $12,089.50 | $20,252.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,962.70 / $12,224.85 / $16,535.68
| Facility | | $7,962.70 | $12,224.85 | $16,535.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,707.17 / $10,929.59 / $17,749.25
| Facility | | $5,707.17 | $10,929.59 | $17,749.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,209.25 / $12,625.12 / $17,309.25
| Facility | | $9,209.25 | $12,625.12 | $17,309.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,766.20 / $9,738.77 / $25,369.75
| Facility | | $3,766.20 | $9,738.77 | $25,369.75 |