- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,089.70 / $16,650.09 / $23,574.80
| Facility | | $9,089.70 | $16,650.09 | $23,574.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,458.35 / $16,872.48 / $26,575.38
| Facility | | $10,458.35 | $16,872.48 | $26,575.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,450.54 / $14,977.67 / $26,647.66
| Facility | | $9,450.54 | $14,977.67 | $26,647.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,013.98 / $13,868.96 / $31,510.91
| Facility | | $6,013.98 | $13,868.96 | $31,510.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,823.56 / $28,002.24
| Facility | | $3,308.00 | $13,823.56 | $28,002.24 |