- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $13,803.84 / $23,442.29
| Facility | | $11,481.54 | $13,803.84 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $14,791.08 / $14,791.08
| Facility | | $14,791.08 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,803.84 / $22,387.21
| Facility | | $8,128.31 | $13,803.84 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $18,620.87 / $23,988.33
| Facility | | $12,022.64 | $18,620.87 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $17,782.79 / $27,542.29
| Facility | | $10,715.19 | $17,782.79 | $27,542.29 |