- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,405.70 / $16,655.70 / $21,891.30
| Facility | | $11,405.70 | $16,655.70 | $21,891.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,274.95 / $17,089.06 / $28,903.84
| Facility | | $6,274.95 | $17,089.06 | $28,903.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,586.59 / $16,729.66 / $29,978.54
| Facility | | $11,586.59 | $16,729.66 | $29,978.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,346.77 / $18,670.54 / $27,260.50
| Facility | | $14,346.77 | $18,670.54 | $27,260.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,346.77 / $17,356.75 / $27,260.50
| Facility | | $14,346.77 | $17,356.75 | $27,260.50 |