- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,315.16 / $12,220.40 / $18,867.20
| Facility | | $8,315.16 | $12,220.40 | $18,867.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,966.24 / $25,541.69 / $32,745.76
| Facility | | $17,966.24 | $25,541.69 | $32,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,358.42 / $18,093.62 / $22,885.16
| Facility | | $9,358.42 | $18,093.62 | $22,885.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,315.16 / $12,499.30 / $19,986.90
| Facility | | $8,315.16 | $12,499.30 | $19,986.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,724.48 / $16,628.99 / $25,264.27
| Facility | | $9,724.48 | $16,628.99 | $25,264.27 |