- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,053.00 / $10,285.60 / $16,696.80
| Facility | | $7,053.00 | $10,285.60 | $16,696.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,622.41 / $27,896.19 / $35,764.35
| Facility | | $19,622.41 | $27,896.19 | $35,764.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,281.87 / $16,012.24 / $20,252.58
| Facility | | $8,281.87 | $16,012.24 | $20,252.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,358.63 / $11,061.50 / $17,687.80
| Facility | | $7,358.63 | $11,061.50 | $17,687.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,605.84 / $14,716.08 / $22,358.01
| Facility | | $8,605.84 | $14,716.08 | $22,358.01 |