- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,281.70 / $13,193.20 / $21,903.80
| Facility | | $10,281.70 | $13,193.20 | $21,903.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,843.15 / $12,006.62 / $19,903.90
| Facility | | $7,843.15 | $12,006.62 | $19,903.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,372.08 / $14,072.02 / $20,233.84
| Facility | | $11,372.08 | $14,072.02 | $20,233.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,069.38 / $14,127.44 / $35,071.47
| Facility | | $7,069.38 | $14,127.44 | $35,071.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,069.38 / $13,488.37 / $18,957.24
| Facility | | $7,069.38 | $13,488.37 | $18,957.24 |