- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,334.21 / $13,630.70 / $17,915.50
| Facility | | $9,334.21 | $13,630.70 | $17,915.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,802.10 / $7,723.49 / $12,907.13
| Facility | | $2,802.10 | $7,723.49 | $12,907.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,482.29 / $13,691.32 / $22,916.17
| Facility | | $9,482.29 | $13,691.32 | $22,916.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,741.18 / $15,279.69 / $22,309.59
| Facility | | $11,741.18 | $15,279.69 | $22,309.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,741.18 / $14,204.51 / $22,309.59
| Facility | | $11,741.18 | $14,204.51 | $22,309.59 |