- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,075.40 / $11,776.60 / $19,117.20
| Facility | | $8,075.40 | $11,776.60 | $19,117.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,737.50 / $26,638.15 / $34,151.48
| Facility | | $18,737.50 | $26,638.15 | $34,151.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,482.42 / $18,491.05 / $26,860.13
| Facility | | $9,482.42 | $18,491.05 | $26,860.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,425.33 / $12,664.90 / $20,251.80
| Facility | | $8,425.33 | $12,664.90 | $20,251.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,853.33 / $16,849.32 / $25,599.02
| Facility | | $9,853.33 | $16,849.32 | $25,599.02 |