- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,210.10 / $14,271.30 / $23,166.70
| Facility | | $10,210.10 | $14,271.30 | $23,166.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,244.29 / $28,780.28 / $36,897.80
| Facility | | $20,244.29 | $28,780.28 | $36,897.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,491.06 / $22,216.89 / $28,100.35
| Facility | | $11,491.06 | $22,216.89 | $28,100.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,210.10 / $15,347.70 / $24,541.70
| Facility | | $10,210.10 | $15,347.70 | $24,541.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,940.55 / $20,418.49 / $31,021.62
| Facility | | $11,940.55 | $20,418.49 | $31,021.62 |