- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,860.54 / $16,230.40 / $22,980.50
| Facility | | $8,860.54 | $16,230.40 | $22,980.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,091.36 / $14,580.33 / $22,932.95
| Facility | | $9,091.36 | $14,580.33 | $22,932.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,212.28 / $14,600.07 / $25,975.84
| Facility | | $9,212.28 | $14,600.07 | $25,975.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,862.36 / $13,624.94 / $30,716.48
| Facility | | $5,862.36 | $13,624.94 | $30,716.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,475.05 / $27,296.26
| Facility | | $3,308.00 | $13,475.05 | $27,296.26 |