- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,271.06 / $13,625.20 / $21,036.10
| Facility | | $9,271.06 | $13,625.20 | $21,036.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,212.49 / $20,430.11 / $20,514.45
| Facility | | $17,212.49 | $20,430.11 | $20,514.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,612.27 / $25,038.48 / $32,100.61
| Facility | | $17,612.27 | $25,038.48 | $32,100.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,434.25 / $20,173.65 / $25,516.02
| Facility | | $10,434.25 | $20,173.65 | $25,516.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,271.06 / $13,936.20 / $22,284.60
| Facility | | $9,271.06 | $13,936.20 | $22,284.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,842.40 / $18,540.64 / $28,168.62
| Facility | | $10,842.40 | $18,540.64 | $28,168.62 |