- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,595.87 / $25,118.86
| Facility | | $12,022.64 | $16,595.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $22,387.21
| Facility | | $9,549.93 | $14,791.08 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,454.40 / $25,703.96
| Facility | | $10,471.29 | $14,454.40 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $162.18 / $245.47
| Facility | | $109.65 | $162.18 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $23,442.29
| Facility | | $10,715.19 | $16,218.10 | $23,442.29 |