- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,440.40 / $20,636.50 / $27,692.50
| Facility | | $12,440.40 | $20,636.50 | $27,692.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,528.48 / $14,091.10 / $17,408.34
| Facility | | $12,528.48 | $14,091.10 | $17,408.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,206.20 / $17,534.52 / $28,055.90
| Facility | | $10,206.20 | $17,534.52 | $28,055.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,215.20 / $16,615.50 / $38,105.99
| Facility | | $10,215.20 | $16,615.50 | $38,105.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,128.21 / $16,367.38 / $23,186.38
| Facility | | $12,128.21 | $16,367.38 | $23,186.38 |