- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,136.46 / $13,427.40 / $20,730.70
| Facility | | $9,136.46 | $13,427.40 | $20,730.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,891.55 / $25,435.51 / $32,609.63
| Facility | | $17,891.55 | $25,435.51 | $32,609.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,282.78 / $19,880.78 / $25,145.59
| Facility | | $10,282.78 | $19,880.78 | $25,145.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,136.46 / $13,733.90 / $21,961.10
| Facility | | $9,136.46 | $13,733.90 | $21,961.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,685.00 / $18,271.48 / $27,759.69
| Facility | | $10,685.00 | $18,271.48 | $27,759.69 |