- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,215.51 / $13,457.40 / $17,687.59
| Facility | | $9,215.51 | $13,457.40 | $17,687.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,310.55 / $9,015.89 / $15,249.16
| Facility | | $3,310.55 | $9,015.89 | $15,249.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,796.93 / $13,625.99 / $25,138.11
| Facility | | $9,796.93 | $13,625.99 | $25,138.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,591.85 / $15,085.36 / $22,025.85
| Facility | | $11,591.85 | $15,085.36 | $22,025.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,590.11 / $14,516.40 / $22,025.85
| Facility | | $9,590.11 | $14,516.40 | $22,025.85 |