- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,264.80 / $16,449.90 / $21,620.80
| Facility | | $11,264.80 | $16,449.90 | $21,620.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,901.59 / $16,072.25 / $27,184.04
| Facility | | $5,901.59 | $16,072.25 | $27,184.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,856.67 / $16,599.14 / $29,608.18
| Facility | | $11,856.67 | $16,599.14 | $29,608.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,169.53 / $18,439.88 / $26,923.73
| Facility | | $14,169.53 | $18,439.88 | $26,923.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,169.53 / $17,142.33 / $26,923.73
| Facility | | $14,169.53 | $17,142.33 | $26,923.73 |