- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $11,481.54 / $17,782.79
| Facility | | $9,549.93 | $11,481.54 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $18,197.01 / $24,547.09
| Facility | | $12,882.50 | $18,197.01 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $15,135.61 / $20,892.96
| Facility | | $12,302.69 | $15,135.61 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,135.61 / $19,952.62
| Facility | | $9,120.11 | $15,135.61 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,125.38 / $20,892.96
| Facility | | $9,120.11 | $14,125.38 | $20,892.96 |