- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $17,378.01 / $23,442.29
| Facility | | $9,120.11 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,489.63 / $21,379.62
| Facility | | $9,120.11 | $13,489.63 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $18,620.87 / $25,118.86
| Facility | | $8,912.51 | $18,620.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $12,589.25 / $27,542.29
| Facility | | $5,754.40 | $12,589.25 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $13,489.63 / $26,302.68
| Facility | | $5,248.07 | $13,489.63 | $26,302.68 |