- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,878.56 / $13,048.40 / $20,145.50
| Facility | | $8,878.56 | $13,048.40 | $20,145.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,337.27 / $20,382.57 / $26,131.50
| Facility | | $14,337.27 | $20,382.57 | $26,131.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,992.51 / $19,319.57 / $24,435.76
| Facility | | $9,992.51 | $19,319.57 | $24,435.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,878.56 / $13,346.20 / $21,341.20
| Facility | | $8,878.56 | $13,346.20 | $21,341.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,383.37 / $17,755.70 / $26,976.07
| Facility | | $10,383.37 | $17,755.70 | $26,976.07 |