- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,489.63 / $17,378.01
| Facility | | $9,120.11 | $13,489.63 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $5,623.41 / $12,302.69
| Facility | | $3,090.30 | $5,623.41 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $6,606.93 / $12,302.69
| Facility | | $4,786.30 | $6,606.93 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $6,606.93 / $12,302.69
| Facility | | $4,786.30 | $6,606.93 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $8,317.64 / $13,489.63
| Facility | | $3,548.13 | $8,317.64 | $13,489.63 |