- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,613.41 / $17,609.40 / $24,933.10
| Facility | | $9,613.41 | $17,609.40 | $24,933.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,350.48 / $16,765.80 / $27,679.68
| Facility | | $10,350.48 | $16,765.80 | $27,679.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,995.04 / $15,840.62 / $28,182.98
| Facility | | $9,995.04 | $15,840.62 | $28,182.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,360.48 / $14,142.98 / $33,326.43
| Facility | | $6,360.48 | $14,142.98 | $33,326.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,620.02 / $29,615.61
| Facility | | $3,308.00 | $14,620.02 | $29,615.61 |