- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,526.20 / $13,892.40 / $22,551.70
| Facility | | $9,526.20 | $13,892.40 | $22,551.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,780.91 / $35,229.76 / $45,166.36
| Facility | | $24,780.91 | $35,229.76 | $45,166.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,186.00 / $21,627.08 / $27,354.34
| Facility | | $11,186.00 | $21,627.08 | $27,354.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,939.00 / $14,940.30 / $23,890.10
| Facility | | $9,939.00 | $14,940.30 | $23,890.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,623.55 / $19,876.41 / $30,198.05
| Facility | | $11,623.55 | $19,876.41 | $30,198.05 |