- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,812.20 / $12,851.10 / $20,861.40
| Facility | | $8,812.20 | $12,851.10 | $20,861.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,883.83 / $28,267.83 / $36,240.81
| Facility | | $19,883.83 | $28,267.83 | $36,240.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,347.59 / $20,006.09 / $25,304.10
| Facility | | $10,347.59 | $20,006.09 | $25,304.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,194.06 / $13,820.50 / $22,099.50
| Facility | | $9,194.06 | $13,820.50 | $22,099.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,752.35 / $18,386.66 / $27,934.67
| Facility | | $10,752.35 | $18,386.66 | $27,934.67 |