- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,895.33 / $13,107.70 / $22,933.60
| Facility | | $9,895.33 | $13,107.70 | $22,933.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.03 / $10,205.66 / $19,026.39
| Facility | | $6,548.03 | $10,205.66 | $19,026.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,129.12 / $21,674.24
| Facility | | $5,843.91 | $11,129.12 | $21,674.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,181.00 / $13,312.91 / $20,475.68
| Facility | | $9,181.00 | $13,312.91 | $20,475.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,414.67 / $20,632.03
| Facility | | $3,496.00 | $13,414.67 | $20,632.03 |