- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,848.93 / $27,542.29
| Facility | | $12,589.25 | $15,848.93 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $21,379.62 / $25,703.96
| Facility | | $14,791.08 | $21,379.62 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,218.10 / $26,915.35
| Facility | | $9,549.93 | $16,218.10 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $21,379.62 / $28,183.83
| Facility | | $13,489.63 | $21,379.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,892.96 / $32,359.37
| Facility | | $12,302.69 | $20,892.96 | $32,359.37 |