- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,624.60 / $14,035.90 / $22,784.60
| Facility | | $9,624.60 | $14,035.90 | $22,784.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,943.20 / $18,956.22 / $31,089.37
| Facility | | $13,943.20 | $18,956.22 | $31,089.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,385.16 / $26,137.25 / $33,509.29
| Facility | | $18,385.16 | $26,137.25 | $33,509.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,301.54 / $21,850.47 / $27,636.89
| Facility | | $11,301.54 | $21,850.47 | $27,636.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,041.70 / $15,094.60 / $24,136.90
| Facility | | $10,041.70 | $15,094.60 | $24,136.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,743.62 / $20,081.73 / $30,509.98
| Facility | | $11,743.62 | $20,081.73 | $30,509.98 |