- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,796.20 / $14,286.10 / $23,190.90
| Facility | | $9,796.20 | $14,286.10 | $23,190.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,937.07 / $18,937.07 / $18,937.07
| Facility | | $18,937.07 | $18,937.07 | $18,937.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,846.09 / $25,370.88 / $32,526.77
| Facility | | $17,846.09 | $25,370.88 | $32,526.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,503.04 / $22,240.05 / $28,129.64
| Facility | | $11,503.04 | $22,240.05 | $28,129.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,220.70 / $15,363.70 / $24,567.20
| Facility | | $10,220.70 | $15,363.70 | $24,567.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,953.00 / $20,439.77 / $31,053.95
| Facility | | $11,953.00 | $20,439.77 | $31,053.95 |