- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.17 / $16,705.90 / $23,653.80
| Facility | | $9,120.17 | $16,705.90 | $23,653.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,199.45 / $10,199.45 / $17,287.93
| Facility | | $10,199.45 | $10,199.45 | $17,287.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,445.56 / $15,291.66 / $24,203.45
| Facility | | $9,445.56 | $15,291.66 | $24,203.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,482.21 / $15,027.88 / $26,736.99
| Facility | | $9,482.21 | $15,027.88 | $26,736.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,034.14 / $14,178.79 / $31,616.54
| Facility | | $6,034.14 | $14,178.79 | $31,616.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,034.14 / $15,017.74 / $31,616.54
| Facility | | $6,034.14 | $15,017.74 | $31,616.54 |