- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $11,220.18 / $17,782.79
| Facility | | $9,332.54 | $11,220.18 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,197.01 / $23,988.33
| Facility | | $12,589.25 | $18,197.01 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,791.08 / $20,417.38
| Facility | | $12,022.64 | $14,791.08 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $14,791.08 / $19,498.45
| Facility | | $8,912.51 | $14,791.08 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $20,892.96
| Facility | | $8,912.51 | $13,803.84 | $20,892.96 |