- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $11,748.98 / $18,197.01
| Facility | | $9,332.54 | $11,748.98 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,709.64 / $15,135.61
| Facility | | $5,623.41 | $8,709.64 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $11,481.54 / $17,378.01
| Facility | | $5,370.32 | $11,481.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,549.93 / $17,378.01
| Facility | | $6,760.83 | $9,549.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $9,332.54 / $14,125.38
| Facility | | $3,311.31 | $9,332.54 | $14,125.38 |