- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,964.78 / $19,054.61
| Facility | | $8,912.51 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,471.29 / $15,848.93
| Facility | | $10,471.29 | $10,471.29 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,220.18 / $18,197.01
| Facility | | $6,606.93 | $11,220.18 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $19,498.45
| Facility | | $9,549.93 | $14,791.08 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $21,379.62
| Facility | | $8,912.51 | $13,803.84 | $21,379.62 |