- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,472.62 / $13,921.40 / $21,493.50
| Facility | | $9,472.62 | $13,921.40 | $21,493.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,097.75 / $25,728.67 / $32,985.47
| Facility | | $18,097.75 | $25,728.67 | $32,985.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,661.11 / $20,612.27 / $26,070.79
| Facility | | $10,661.11 | $20,612.27 | $26,070.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,472.62 / $14,239.20 / $22,769.10
| Facility | | $9,472.62 | $14,239.20 | $22,769.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,078.14 / $18,943.75 / $28,781.06
| Facility | | $11,078.14 | $18,943.75 | $28,781.06 |