- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,213.80 / $10,520.10 / $17,077.50
| Facility | | $7,213.80 | $10,520.10 | $17,077.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,055.34 / $24,246.72 / $31,085.54
| Facility | | $17,055.34 | $24,246.72 | $31,085.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,470.70 / $16,377.30 / $20,714.32
| Facility | | $8,470.70 | $16,377.30 | $20,714.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,526.40 / $11,313.60 / $18,091.00
| Facility | | $7,526.40 | $11,313.60 | $18,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,802.04 / $15,051.59 / $22,867.75
| Facility | | $8,802.04 | $15,051.59 | $22,867.75 |