- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,718.50 / $17,112.59 / $22,491.80
| Facility | | $11,718.50 | $17,112.59 | $22,491.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,232.05 / $13,232.05 / $17,388.75
| Facility | | $13,232.05 | $13,232.05 | $17,388.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,254.33 / $19,756.27 / $33,415.07
| Facility | | $7,254.33 | $19,756.27 | $33,415.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,904.43 / $17,188.59 / $28,769.83
| Facility | | $11,904.43 | $17,188.59 | $28,769.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,740.33 / $19,182.70 / $28,008.31
| Facility | | $14,740.33 | $19,182.70 | $28,008.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,740.33 / $17,832.88 / $28,008.31
| Facility | | $14,740.33 | $17,832.88 | $28,008.31 |