- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,739.10 / $17,839.70 / $25,259.10
| Facility | | $9,739.10 | $17,839.70 | $25,259.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,105.73 / $16,065.51 / $25,425.39
| Facility | | $10,105.73 | $16,065.51 | $25,425.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,125.71 / $20,496.91 / $28,551.46
| Facility | | $10,125.71 | $20,496.91 | $28,551.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,443.64 / $14,811.17 / $33,762.16
| Facility | | $6,443.64 | $14,811.17 | $33,762.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,740.00 / $30,002.82
| Facility | | $3,308.00 | $14,740.00 | $30,002.82 |