- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,543.77 / $15,650.10 / $22,158.90
| Facility | | $8,543.77 | $15,650.10 | $22,158.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,097.37 / $14,583.10 / $22,948.79
| Facility | | $9,097.37 | $14,583.10 | $22,948.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,882.94 / $14,078.11 / $25,047.20
| Facility | | $8,882.94 | $14,078.11 | $25,047.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,652.78 / $13,656.85 / $29,618.36
| Facility | | $5,652.78 | $13,656.85 | $29,618.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,993.32 / $26,320.42
| Facility | | $3,308.00 | $12,993.32 | $26,320.42 |