- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,848.60 / $15,820.90 / $25,682.30
| Facility | | $10,848.60 | $15,820.90 | $25,682.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,701.78 / $26,587.37 / $34,086.37
| Facility | | $18,701.78 | $26,587.37 | $34,086.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,738.81 / $24,629.29 / $31,151.59
| Facility | | $12,738.81 | $24,629.29 | $31,151.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,318.70 / $17,014.20 / $27,206.50
| Facility | | $11,318.70 | $17,014.20 | $27,206.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,237.10 / $22,635.60 / $34,390.06
| Facility | | $13,237.10 | $22,635.60 | $34,390.06 |