- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,284.20 / $12,081.10 / $19,611.50
| Facility | | $8,284.20 | $12,081.10 | $19,611.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,397.35 / $20,467.98 / $26,241.00
| Facility | | $14,397.35 | $20,467.98 | $26,241.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,727.60 / $18,807.40 / $23,787.96
| Facility | | $9,727.60 | $18,807.40 | $23,787.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,643.18 / $12,992.40 / $20,775.40
| Facility | | $8,643.18 | $12,992.40 | $20,775.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,108.10 / $17,284.98 / $26,260.91
| Facility | | $10,108.10 | $17,284.98 | $26,260.91 |