- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,779.40 / $14,261.60 / $23,151.10
| Facility | | $9,779.40 | $14,261.60 | $23,151.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,925.82 / $38,279.07 / $49,075.73
| Facility | | $26,925.82 | $38,279.07 | $49,075.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,483.31 / $22,201.91 / $28,081.40
| Facility | | $11,483.31 | $22,201.91 | $28,081.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,203.20 / $15,337.40 / $24,525.10
| Facility | | $10,203.20 | $15,337.40 | $24,525.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,932.50 / $20,404.72 / $31,000.70
| Facility | | $11,932.50 | $20,404.72 | $31,000.70 |