- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $16,595.87 / $22,908.68
| Facility | | $8,912.51 | $16,595.87 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,791.08 / $23,988.33
| Facility | | $9,772.37 | $14,791.08 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $17,782.79 / $24,547.09
| Facility | | $8,709.64 | $17,782.79 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,882.50 / $26,915.35
| Facility | | $5,495.41 | $12,882.50 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $12,882.50 / $25,703.96
| Facility | | $5,248.07 | $12,882.50 | $25,703.96 |