- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,093.79 / $12,826.90 / $21,295.70
| Facility | | $8,093.79 | $12,826.90 | $21,295.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,439.06 / $11,253.97 / $18,878.43
| Facility | | $7,439.06 | $11,253.97 | $18,878.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,056.38 / $13,681.37 / $19,672.14
| Facility | | $11,056.38 | $13,681.37 | $19,672.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,873.13 / $13,142.51 / $33,264.56
| Facility | | $6,873.13 | $13,142.51 | $33,264.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,873.13 / $13,113.92 / $18,430.97
| Facility | | $6,873.13 | $13,113.92 | $18,430.97 |