- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,178.89 / $13,403.90 / $17,617.40
| Facility | | $9,178.89 | $13,403.90 | $17,617.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,278.67 / $11,652.44 / $19,708.54
| Facility | | $4,278.67 | $11,652.44 | $19,708.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,324.50 / $13,463.48 / $22,534.82
| Facility | | $9,324.50 | $13,463.48 | $22,534.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,545.80 / $15,025.42 / $21,938.34
| Facility | | $11,545.80 | $15,025.42 | $21,938.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,545.80 / $13,968.13 / $21,938.34
| Facility | | $11,545.80 | $13,968.13 | $21,938.34 |