- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $12,022.64 / $15,848.93
| Facility | | $7,413.10 | $12,022.64 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,489.63 / $16,595.87
| Facility | | $9,120.11 | $13,489.63 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $14,125.38
| Facility | | $14,125.38 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,220.18 / $14,791.08
| Facility | | $7,585.78 | $11,220.18 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $14,125.38
| Facility | | $14,125.38 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,471.29 / $16,218.10
| Facility | | $6,606.93 | $10,471.29 | $16,218.10 |