- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.62 / $16,567.59 / $23,457.90
| Facility | | $9,044.62 | $16,567.59 | $23,457.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,749.29 / $15,799.17 / $25,059.37
| Facility | | $9,749.29 | $15,799.17 | $25,059.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,403.68 / $14,903.41 / $26,515.53
| Facility | | $9,403.68 | $14,903.41 | $26,515.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,984.16 / $14,344.26 / $31,354.66
| Facility | | $5,984.16 | $14,344.26 | $31,354.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,755.02 / $27,863.39
| Facility | | $3,308.00 | $13,755.02 | $27,863.39 |