- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $11,748.98 / $17,782.79
| Facility | | $9,772.37 | $11,748.98 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $17,782.79 / $24,547.09
| Facility | | $13,182.57 | $17,782.79 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $14,791.08 / $21,379.62
| Facility | | $12,302.69 | $14,791.08 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,135.61 / $20,417.38
| Facility | | $9,120.11 | $15,135.61 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,125.38 / $21,379.62
| Facility | | $9,120.11 | $14,125.38 | $21,379.62 |