- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,371.40 / $13,666.60 / $22,185.20
| Facility | | $9,371.40 | $13,666.60 | $22,185.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,791.88 / $32,402.06 / $41,541.10
| Facility | | $22,791.88 | $32,402.06 | $41,541.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,004.23 / $21,275.64 / $26,909.83
| Facility | | $11,004.23 | $21,275.64 | $26,909.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,777.49 / $14,697.50 / $23,501.90
| Facility | | $9,777.49 | $14,697.50 | $23,501.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,434.67 / $19,553.43 / $29,707.34
| Facility | | $11,434.67 | $19,553.43 | $29,707.34 |