- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,411.28 / $13,831.30 / $21,354.30
| Facility | | $9,411.28 | $13,831.30 | $21,354.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,363.84 / $24,685.30 / $31,647.82
| Facility | | $17,363.84 | $24,685.30 | $31,647.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,592.07 / $20,478.77 / $25,901.94
| Facility | | $10,592.07 | $20,478.77 | $25,901.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,411.28 / $14,147.00 / $22,621.70
| Facility | | $9,411.28 | $14,147.00 | $22,621.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,006.39 / $18,821.06 / $28,594.67
| Facility | | $11,006.39 | $18,821.06 | $28,594.67 |