- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,022.64 / $18,620.87
| Facility | | $9,332.54 | $12,022.64 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,022.64 / $17,782.79
| Facility | | $8,128.31 | $12,022.64 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,882.50 / $17,378.01
| Facility | | $6,165.95 | $12,882.50 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $9,549.93 / $17,782.79
| Facility | | $6,918.31 | $9,549.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $9,332.54 / $14,454.40
| Facility | | $3,311.31 | $9,332.54 | $14,454.40 |