- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,882.66 / $12,971.30 / $17,048.80
| Facility | | $8,882.66 | $12,971.30 | $17,048.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,258.99 / $14,322.21 / $24,224.09
| Facility | | $5,258.99 | $14,322.21 | $24,224.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,023.56 / $13,028.96 / $21,807.54
| Facility | | $9,023.56 | $13,028.96 | $21,807.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,173.17 / $14,540.50 / $21,230.31
| Facility | | $11,173.17 | $14,540.50 | $21,230.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,173.17 / $13,517.33 / $21,230.31
| Facility | | $11,173.17 | $13,517.33 | $21,230.31 |