- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,867.80 / $15,848.90 / $25,727.70
| Facility | | $10,867.80 | $15,848.90 | $25,727.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,619.16 / $27,891.58 / $35,758.43
| Facility | | $19,619.16 | $27,891.58 | $35,758.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,761.35 / $24,672.88 / $31,206.72
| Facility | | $12,761.35 | $24,672.88 | $31,206.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,338.70 / $17,044.30 / $27,254.60
| Facility | | $11,338.70 | $17,044.30 | $27,254.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,260.53 / $22,675.66 / $34,450.93
| Facility | | $13,260.53 | $22,675.66 | $34,450.93 |