- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $17,782.79 / $23,988.33
| Facility | | $9,549.93 | $17,782.79 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,454.40 / $23,442.29
| Facility | | $9,549.93 | $14,454.40 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $19,054.61 / $25,703.96
| Facility | | $9,120.11 | $19,054.61 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $13,489.63 / $28,183.83
| Facility | | $5,888.44 | $13,489.63 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $13,803.84 / $27,542.29
| Facility | | $5,248.07 | $13,803.84 | $27,542.29 |