- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $13,489.63 / $19,498.45
| Facility | | $10,964.78 | $13,489.63 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $21,379.62 / $28,183.83
| Facility | | $15,135.61 | $21,379.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $17,378.01 / $24,547.09
| Facility | | $14,125.38 | $17,378.01 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $17,378.01 / $23,442.29
| Facility | | $10,471.29 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,218.10 / $24,547.09
| Facility | | $10,471.29 | $16,218.10 | $24,547.09 |