- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,490.72 / $11,008.70 / $16,996.50
| Facility | | $7,490.72 | $11,008.70 | $16,996.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,516.87 / $27,746.15 / $35,571.99
| Facility | | $19,516.87 | $27,746.15 | $35,571.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,430.54 / $16,299.65 / $20,616.11
| Facility | | $8,430.54 | $16,299.65 | $20,616.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,490.72 / $11,260.00 / $18,005.20
| Facility | | $7,490.72 | $11,260.00 | $18,005.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,760.31 / $14,980.24 / $22,759.33
| Facility | | $8,760.31 | $14,980.24 | $22,759.33 |