- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,595.87 / $25,703.96
| Facility | | $11,748.98 | $16,595.87 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,125.38 / $22,908.68
| Facility | | $9,772.37 | $14,125.38 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,125.38 / $24,547.09
| Facility | | $9,549.93 | $14,125.38 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $14,125.38 / $23,988.33
| Facility | | $7,079.46 | $14,125.38 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,964.78 / $18,620.87
| Facility | | $6,918.31 | $10,964.78 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $18,620.87 / $25,703.96
| Facility | | $7,585.78 | $18,620.87 | $25,703.96 |