- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,498.45 / $27,542.29
| Facility | | $12,882.50 | $19,498.45 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $14,454.40 / $23,988.33
| Facility | | $5,370.32 | $14,454.40 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $16,218.10 / $27,542.29
| Facility | | $11,481.54 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $17,782.79 / $25,703.96
| Facility | | $14,125.38 | $17,782.79 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $17,378.01 / $25,118.86
| Facility | | $9,120.11 | $17,378.01 | $25,118.86 |