- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $9,120.11 / $17,782.79
| Facility | | $7,585.78 | $9,120.11 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $14,791.08 / $19,498.45
| Facility | | $10,232.93 | $14,791.08 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,022.64 / $16,595.87
| Facility | | $9,772.37 | $12,022.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $12,022.64 / $15,848.93
| Facility | | $7,244.36 | $12,022.64 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $16,595.87
| Facility | | $7,244.36 | $11,220.18 | $16,595.87 |