- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,362.79 / $15,229.70 / $23,513.30
| Facility | | $10,362.79 | $15,229.70 | $23,513.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,668.67 / $33,648.55 / $43,139.17
| Facility | | $23,668.67 | $33,648.55 | $43,139.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,662.97 / $22,743.21 / $33,036.82
| Facility | | $11,662.97 | $22,743.21 | $33,036.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,362.79 / $15,577.30 / $24,908.80
| Facility | | $10,362.79 | $15,577.30 | $24,908.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,119.18 / $20,723.95 / $31,485.71
| Facility | | $12,119.18 | $20,723.95 | $31,485.71 |