- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,378.90 / $16,817.80 / $26,480.70
| Facility | | $12,378.90 | $16,817.80 | $26,480.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,962.16 / $15,374.55 / $22,510.76
| Facility | | $9,962.16 | $15,374.55 | $22,510.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,400.98 / $14,431.00 / $26,781.62
| Facility | | $10,400.98 | $14,431.00 | $26,781.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.06 / $140.58 / $224.05
| Facility | | $102.06 | $140.58 | $224.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,894.55 / $16,461.59 / $27,091.94
| Facility | | $11,894.55 | $16,461.59 | $27,091.94 |