- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,237.79 / $15,089.70 / $21,365.30
| Facility | | $8,237.79 | $15,089.70 | $21,365.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,168.68 / $14,820.70 / $23,566.95
| Facility | | $9,168.68 | $14,820.70 | $23,566.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,564.82 / $13,573.94 / $24,150.20
| Facility | | $8,564.82 | $13,573.94 | $24,150.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,450.34 / $13,336.65 / $28,557.65
| Facility | | $5,450.34 | $13,336.65 | $28,557.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,528.00 / $25,377.82
| Facility | | $3,308.00 | $12,528.00 | $25,377.82 |