- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,803.84 / $18,620.87
| Facility | | $8,709.64 | $13,803.84 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,489.63 / $18,197.01
| Facility | | $9,120.11 | $13,489.63 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $18,620.87
| Facility | | $7,585.78 | $12,302.69 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $19,952.62
| Facility | | $9,549.93 | $13,182.57 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $13,489.63 / $19,952.62
| Facility | | $4,466.84 | $13,489.63 | $19,952.62 |