- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,366.20 / $15,117.40 / $24,540.30
| Facility | | $10,366.20 | $15,117.40 | $24,540.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,488.09 / $20,488.09 / $30,570.89
| Facility | | $20,488.09 | $20,488.09 | $30,570.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,573.27 / $36,336.83 / $46,610.55
| Facility | | $25,573.27 | $36,336.83 | $46,610.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,172.35 / $23,534.11 / $29,766.39
| Facility | | $12,172.35 | $23,534.11 | $29,766.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,815.40 / $16,257.70 / $25,996.70
| Facility | | $10,815.40 | $16,257.70 | $25,996.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,648.49 / $21,629.08 / $32,860.85
| Facility | | $12,648.49 | $21,629.08 | $32,860.85 |