- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,628.61 / $12,754.40 / $22,315.40
| Facility | | $9,628.61 | $12,754.40 | $22,315.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,924.82 / $10,454.40 / $17,434.07
| Facility | | $9,924.82 | $10,454.40 | $17,434.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,883.57 / $22,141.81
| Facility | | $5,843.91 | $11,883.57 | $22,141.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,181.00 / $13,067.57 / $19,923.75
| Facility | | $9,181.00 | $13,067.57 | $19,923.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,144.04 / $20,075.90
| Facility | | $3,496.00 | $13,144.04 | $20,075.90 |