- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $19,498.45
| Facility | | $10,715.19 | $15,135.61 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,182.57 / $18,620.87
| Facility | | $9,120.11 | $13,182.57 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $15,848.93 / $22,387.21
| Facility | | $8,317.64 | $15,848.93 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $16,982.44 / $19,498.45
| Facility | | $9,772.37 | $16,982.44 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $15,848.93 / $22,387.21
| Facility | | $8,128.31 | $15,848.93 | $22,387.21 |