- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,179.40 / $13,386.60 / $21,730.70
| Facility | | $9,179.40 | $13,386.60 | $21,730.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,421.70 / $20,502.59 / $26,285.39
| Facility | | $14,421.70 | $20,502.59 | $26,285.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,778.77 / $20,839.75 / $26,358.51
| Facility | | $10,778.77 | $20,839.75 | $26,358.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,577.17 / $14,396.40 / $23,020.40
| Facility | | $9,577.17 | $14,396.40 | $23,020.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,200.40 / $19,152.82 / $29,098.70
| Facility | | $11,200.40 | $19,152.82 | $29,098.70 |