- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,025.32 / $11,794.40 / $18,486.40
| Facility | | $8,025.32 | $11,794.40 | $18,486.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,440.99 / $19,108.37 / $24,497.91
| Facility | | $13,440.99 | $19,108.37 | $24,497.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,032.21 / $17,613.14 / $25,584.87
| Facility | | $9,032.21 | $17,613.14 | $25,584.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,025.32 / $12,063.60 / $19,290.30
| Facility | | $8,025.32 | $12,063.60 | $19,290.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,385.52 / $16,049.36 / $24,383.64
| Facility | | $9,385.52 | $16,049.36 | $24,383.64 |