- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $9,549.93 / $17,782.79
| Facility | | $7,943.28 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $20,417.38
| Facility | | $10,715.19 | $15,135.61 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $12,589.25 / $17,378.01
| Facility | | $10,232.93 | $12,589.25 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $13,182.57 / $16,595.87
| Facility | | $7,585.78 | $13,182.57 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,481.54 / $17,378.01
| Facility | | $7,585.78 | $11,481.54 | $17,378.01 |