- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,882.50 / $24,547.09
| Facility | | $8,317.64 | $12,882.50 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,882.50 / $18,620.87
| Facility | | $9,772.37 | $12,882.50 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,964.78 / $17,782.79
| Facility | | $7,244.36 | $10,964.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $7,762.47 / $17,782.79
| Facility | | $1,949.84 | $7,762.47 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $11,748.98 / $16,595.87
| Facility | | $5,754.40 | $11,748.98 | $16,595.87 |