- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,397.00 / $12,245.60 / $19,878.50
| Facility | | $8,397.00 | $12,245.60 | $19,878.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,522.14 / $30,596.94 / $39,226.85
| Facility | | $21,522.14 | $30,596.94 | $39,226.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,860.04 / $19,063.49 / $24,111.86
| Facility | | $9,860.04 | $19,063.49 | $24,111.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,760.87 / $13,169.30 / $21,058.30
| Facility | | $8,760.87 | $13,169.30 | $21,058.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,530.48 / $17,520.34 / $26,618.49
| Facility | | $11,530.48 | $17,520.34 | $26,618.49 |