- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,882.70 / $17,352.30 / $22,806.90
| Facility | | $11,882.70 | $17,352.30 | $22,806.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,948.54 / $24,568.65 / $41,218.97
| Facility | | $8,948.54 | $24,568.65 | $41,218.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,071.24 / $17,429.45 / $31,232.50
| Facility | | $12,071.24 | $17,429.45 | $31,232.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,946.88 / $19,451.50 / $28,400.78
| Facility | | $14,946.88 | $19,451.50 | $28,400.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,946.88 / $18,082.75 / $28,400.78
| Facility | | $14,946.88 | $18,082.75 | $28,400.78 |