- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,397.20 / $13,704.30 / $22,246.30
| Facility | | $9,397.20 | $13,704.30 | $22,246.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,058.59 / $24,251.34 / $31,091.46
| Facility | | $17,058.59 | $24,251.34 | $31,091.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,034.52 / $21,334.21 / $26,983.92
| Facility | | $11,034.52 | $21,334.21 | $26,983.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,804.41 / $14,737.90 / $23,566.60
| Facility | | $9,804.41 | $14,737.90 | $23,566.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,466.15 / $18,723.91 / $29,446.13
| Facility | | $11,466.15 | $18,723.91 | $29,446.13 |