- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,855.12 / $14,483.60 / $22,701.40
| Facility | | $9,855.12 | $14,483.60 | $22,701.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,975.78 / $24,133.61 / $30,940.53
| Facility | | $16,975.78 | $24,133.61 | $30,940.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,091.59 / $21,628.99 / $31,418.31
| Facility | | $11,091.59 | $21,628.99 | $31,418.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,855.12 / $14,814.20 / $23,688.50
| Facility | | $9,855.12 | $14,814.20 | $23,688.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,525.45 / $19,708.66 / $29,943.19
| Facility | | $11,525.45 | $19,708.66 | $29,943.19 |