- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,584.60 / $15,435.90 / $25,057.30
| Facility | | $10,584.60 | $15,435.90 | $25,057.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,678.45 / $22,289.26 / $28,575.97
| Facility | | $15,678.45 | $22,289.26 | $28,575.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,428.81 / $24,029.94 / $30,393.52
| Facility | | $12,428.81 | $24,029.94 | $30,393.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,043.30 / $16,600.20 / $26,544.40
| Facility | | $11,043.30 | $16,600.20 | $26,544.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,914.98 / $22,084.77 / $33,553.18
| Facility | | $12,914.98 | $22,084.77 | $33,553.18 |