- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,791.08 / $25,703.96
| Facility | | $12,022.64 | $14,791.08 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,952.62 / $29,512.09
| Facility | | $14,125.38 | $19,952.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $15,135.61 / $22,908.68
| Facility | | $8,912.51 | $15,135.61 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,952.62 / $25,703.96
| Facility | | $12,882.50 | $19,952.62 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,197.01 / $28,840.32
| Facility | | $11,748.98 | $18,197.01 | $28,840.32 |