- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,215.35 / $13,543.30 / $20,909.70
| Facility | | $9,215.35 | $13,543.30 | $20,909.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,687.19 / $15,193.44 / $19,478.77
| Facility | | $10,687.19 | $15,193.44 | $19,478.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,371.54 / $20,052.41 / $25,362.68
| Facility | | $10,371.54 | $20,052.41 | $25,362.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,215.35 / $13,852.50 / $22,150.70
| Facility | | $9,215.35 | $13,852.50 | $22,150.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,777.24 / $18,429.22 / $27,999.34
| Facility | | $10,777.24 | $18,429.22 | $27,999.34 |