- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $10,964.78 / $17,782.79
| Facility | | $9,120.11 | $10,964.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $17,378.01 / $23,442.29
| Facility | | $12,302.69 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $14,454.40 / $19,952.62
| Facility | | $11,748.98 | $14,454.40 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $14,454.40 / $19,054.61
| Facility | | $8,709.64 | $14,454.40 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,489.63 / $19,952.62
| Facility | | $8,709.64 | $13,489.63 | $19,952.62 |