- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $18,620.87 / $23,442.29
| Facility | | $13,182.57 | $18,620.87 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,218.10 / $22,387.21
| Facility | | $11,220.18 | $16,218.10 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $19,498.45 / $26,915.35
| Facility | | $10,232.93 | $19,498.45 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $19,054.61 / $21,379.62
| Facility | | $11,220.18 | $19,054.61 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $19,498.45 / $26,915.35
| Facility | | $9,772.37 | $19,498.45 | $26,915.35 |