- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,977.40 / $14,550.40 / $23,619.80
| Facility | | $9,977.40 | $14,550.40 | $23,619.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,235.55 / $35,876.08 / $45,994.99
| Facility | | $25,235.55 | $35,876.08 | $45,994.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,715.81 / $22,651.43 / $28,649.95
| Facility | | $11,715.81 | $22,651.43 | $28,649.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,409.79 / $15,647.90 / $25,021.70
| Facility | | $10,409.79 | $15,647.90 | $25,021.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,174.09 / $20,817.84 / $31,628.36
| Facility | | $12,174.09 | $20,817.84 | $31,628.36 |