- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,659.31 / $14,105.50 / $18,539.40
| Facility | | $9,659.31 | $14,105.50 | $18,539.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,488.81 / $12,224.72 / $20,676.46
| Facility | | $4,488.81 | $12,224.72 | $20,676.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,166.87 / $14,233.44 / $25,388.44
| Facility | | $10,166.87 | $14,233.44 | $25,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,150.09 / $15,811.84 / $23,086.57
| Facility | | $12,150.09 | $15,811.84 | $23,086.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,150.09 / $14,699.21 / $23,086.57
| Facility | | $12,150.09 | $14,699.21 | $23,086.57 |