- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,277.64 / $13,548.10 / $17,806.90
| Facility | | $9,277.64 | $13,548.10 | $17,806.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,354.67 / $14,582.80 / $24,664.84
| Facility | | $5,354.67 | $14,582.80 | $24,664.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,424.81 / $13,608.32 / $22,777.25
| Facility | | $9,424.81 | $13,608.32 | $22,777.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,670.01 / $15,187.06 / $22,174.35
| Facility | | $11,670.01 | $15,187.06 | $22,174.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,670.01 / $14,118.40 / $22,174.35
| Facility | | $11,670.01 | $14,118.40 | $22,174.35 |