- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $17,782.79 / $24,547.09
| Facility | | $9,549.93 | $17,782.79 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $24,547.09
| Facility | | $9,549.93 | $14,791.08 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $19,054.61 / $26,302.68
| Facility | | $9,332.54 | $19,054.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $13,803.84 / $28,183.83
| Facility | | $5,888.44 | $13,803.84 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $13,803.84 / $27,542.29
| Facility | | $5,370.32 | $13,803.84 | $27,542.29 |