- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,516.45 / $13,985.80 / $21,592.90
| Facility | | $9,516.45 | $13,985.80 | $21,592.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,173.25 / $31,522.58 / $40,413.57
| Facility | | $22,173.25 | $31,522.58 | $40,413.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,710.43 / $20,707.62 / $26,191.39
| Facility | | $10,710.43 | $20,707.62 | $26,191.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,516.45 / $14,305.10 / $22,874.40
| Facility | | $9,516.45 | $14,305.10 | $22,874.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,129.38 / $19,031.38 / $28,914.20
| Facility | | $11,129.38 | $19,031.38 | $28,914.20 |