- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,356.50 / $15,220.50 / $23,499.10
| Facility | | $10,356.50 | $15,220.50 | $23,499.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,941.22 / $21,494.90 / $23,236.76
| Facility | | $14,941.22 | $21,494.90 | $23,236.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,819.91 / $23,912.01 / $30,656.42
| Facility | | $16,819.91 | $23,912.01 | $30,656.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,655.93 / $22,535.64 / $28,503.51
| Facility | | $11,655.93 | $22,535.64 | $28,503.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,356.50 / $15,567.90 / $24,893.80
| Facility | | $10,356.50 | $15,567.90 | $24,893.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,111.86 / $20,711.43 / $31,466.69
| Facility | | $12,111.86 | $20,711.43 | $31,466.69 |