- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,625.79 / $14,037.60 / $22,787.50
| Facility | | $9,625.79 | $14,037.60 | $22,787.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,473.00 / $26,257.27 / $33,663.17
| Facility | | $18,473.00 | $26,257.27 | $33,663.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,302.95 / $21,853.20 / $27,640.34
| Facility | | $11,302.95 | $21,853.20 | $27,640.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,042.90 / $15,096.50 / $24,139.90
| Facility | | $10,042.90 | $15,096.50 | $24,139.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,745.08 / $20,084.23 / $30,513.79
| Facility | | $11,745.08 | $20,084.23 | $30,513.79 |