- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $13,489.63 / $23,442.29
| Facility | | $10,715.19 | $13,489.63 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $14,791.08 / $29,512.09
| Facility | | $12,882.50 | $14,791.08 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,803.84 / $22,387.21
| Facility | | $8,128.31 | $13,803.84 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $18,197.01 / $23,442.29
| Facility | | $11,481.54 | $18,197.01 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,595.87 / $25,703.96
| Facility | | $10,715.19 | $16,595.87 | $25,703.96 |