- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $15,488.17 / $21,379.62
| Facility | | $9,332.54 | $15,488.17 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $15,488.17 / $23,442.29
| Facility | | $9,332.54 | $15,488.17 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,982.44 / $28,840.32
| Facility | | $11,220.18 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,218.10 / $21,379.62
| Facility | | $12,022.64 | $16,218.10 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,302.69 / $28,183.83
| Facility | | $4,466.84 | $12,302.69 | $28,183.83 |