- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,759.62 / $12,873.60 / $19,875.70
| Facility | | $8,759.62 | $12,873.60 | $19,875.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,034.01 / $34,167.93 / $43,805.04
| Facility | | $24,034.01 | $34,167.93 | $43,805.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,858.64 / $19,060.75 / $24,108.41
| Facility | | $9,858.64 | $19,060.75 | $24,108.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,759.62 / $13,167.40 / $21,055.30
| Facility | | $8,759.62 | $13,167.40 | $21,055.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,244.28 / $17,517.84 / $26,614.69
| Facility | | $10,244.28 | $17,517.84 | $26,614.69 |