- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,667.90 / $17,422.50
| Facility | | $6,303.00 | $10,667.90 | $17,422.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,089.85 / $19,378.38 / $26,001.60
| Facility | | $14,089.85 | $19,378.38 | $26,001.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,544.17 / $15,853.21 / $22,223.59
| Facility | | $11,544.17 | $15,853.21 | $22,223.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,050.24 / $17,606.75 / $22,196.37
| Facility | | $10,050.24 | $17,606.75 | $22,196.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,050.24 / $17,753.33 / $23,279.92
| Facility | | $10,050.24 | $17,753.33 | $23,279.92 |