- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,604.60 / $15,485.90 / $20,353.80
| Facility | | $10,604.60 | $15,485.90 | $20,353.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,760.90 / $21,135.86 / $35,748.46
| Facility | | $7,760.90 | $21,135.86 | $35,748.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,772.82 / $15,554.69 / $26,035.04
| Facility | | $10,772.82 | $15,554.69 | $26,035.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,339.14 / $17,359.24 / $25,345.90
| Facility | | $13,339.14 | $17,359.24 | $25,345.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,339.14 / $16,137.73 / $25,345.90
| Facility | | $13,339.14 | $16,137.73 | $25,345.90 |