- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,551.40 / $13,929.10 / $22,611.30
| Facility | | $9,551.40 | $13,929.10 | $22,611.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,786.21 / $26,707.40 / $34,240.26
| Facility | | $18,786.21 | $26,707.40 | $34,240.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,215.59 / $21,684.29 / $27,426.70
| Facility | | $11,215.59 | $21,684.29 | $27,426.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,965.29 / $14,979.80 / $23,953.30
| Facility | | $9,965.29 | $14,979.80 | $23,953.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,654.30 / $19,929.00 / $30,277.94
| Facility | | $11,654.30 | $19,929.00 | $30,277.94 |