- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $19,054.61 / $25,703.96
| Facility | | $10,232.93 | $19,054.61 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,791.08 / $23,988.33
| Facility | | $10,232.93 | $14,791.08 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $20,417.38 / $27,542.29
| Facility | | $9,772.37 | $20,417.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $14,791.08 / $30,199.52
| Facility | | $6,309.57 | $14,791.08 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $14,791.08 / $29,512.09
| Facility | | $5,623.41 | $14,791.08 | $29,512.09 |