- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $13,182.57 / $16,982.44
| Facility | | $10,471.29 | $13,182.57 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,964.78 / $16,982.44
| Facility | | $6,918.31 | $10,964.78 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,791.08 / $21,877.62
| Facility | | $9,120.11 | $14,791.08 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $12,882.50 / $19,498.45
| Facility | | $8,912.51 | $12,882.50 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,120.11 / $15,135.61
| Facility | | $5,754.40 | $9,120.11 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $13,182.57 / $19,498.45
| Facility | | $7,413.10 | $13,182.57 | $19,498.45 |