- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,743.96 / $12,850.60 / $19,840.09
| Facility | | $8,743.96 | $12,850.60 | $19,840.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,577.17 / $16,985.32 / $19,253.73
| Facility | | $13,577.17 | $16,985.32 | $19,253.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,106.11 / $15,788.99 / $20,242.30
| Facility | | $11,106.11 | $15,788.99 | $20,242.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,841.03 / $19,026.71 / $24,065.34
| Facility | | $9,841.03 | $19,026.71 | $24,065.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,743.96 / $13,143.90 / $21,017.70
| Facility | | $8,743.96 | $13,143.90 | $21,017.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,225.96 / $17,486.54 / $26,567.14
| Facility | | $10,225.96 | $17,486.54 | $26,567.14 |