- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,165.87 / $16,789.70 / $23,772.40
| Facility | | $9,165.87 | $16,789.70 | $23,772.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,994.50 / $15,855.27 / $24,943.61
| Facility | | $9,994.50 | $15,855.27 | $24,943.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,529.74 / $15,103.19 / $26,870.98
| Facility | | $9,529.74 | $15,103.19 | $26,870.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,064.38 / $13,939.41 / $31,774.98
| Facility | | $6,064.38 | $13,939.41 | $31,774.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,064.38 / $14,723.45 / $31,774.98
| Facility | | $6,064.38 | $14,723.45 | $31,774.98 |