- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,809.20 / $17,221.80 / $27,956.30
| Facility | | $11,809.20 | $17,221.80 | $27,956.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,182.91 / $23,304.88 / $27,082.60
| Facility | | $18,182.91 | $23,304.88 | $27,082.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,925.22 / $34,013.26 / $43,606.76
| Facility | | $23,925.22 | $34,013.26 | $43,606.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,866.78 / $26,810.11 / $33,909.94
| Facility | | $13,866.78 | $26,810.11 | $33,909.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,320.90 / $18,520.80 / $29,615.50
| Facility | | $12,320.90 | $18,520.80 | $29,615.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,409.19 / $24,639.90 / $37,435.16
| Facility | | $14,409.19 | $24,639.90 | $37,435.16 |