- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,604.09 / $14,114.60 / $21,791.80
| Facility | | $9,604.09 | $14,114.60 | $21,791.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,327.30 / $30,319.94 / $38,871.72
| Facility | | $21,327.30 | $30,319.94 | $38,871.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,809.07 / $20,898.32 / $26,432.59
| Facility | | $10,809.07 | $20,898.32 | $26,432.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,604.09 / $14,436.80 / $23,085.10
| Facility | | $9,604.09 | $14,436.80 | $23,085.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.88 / $19,206.65 / $29,180.48
| Facility | | $11,231.88 | $19,206.65 | $29,180.48 |