- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,125.38 / $19,952.62
| Facility | | $10,715.19 | $14,125.38 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $11,481.54 / $19,054.61
| Facility | | $7,079.46 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,982.44 / $25,118.86
| Facility | | $10,471.29 | $16,982.44 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,135.61 / $23,442.29
| Facility | | $10,715.19 | $15,135.61 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $10,715.19 / $17,782.79
| Facility | | $6,760.83 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $13,803.84 / $22,387.21
| Facility | | $7,413.10 | $13,803.84 | $22,387.21 |