- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,282.95 / $13,642.70 / $21,063.10
| Facility | | $9,282.95 | $13,642.70 | $21,063.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,056.77 / $22,827.10 / $29,265.51
| Facility | | $16,056.77 | $22,827.10 | $29,265.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,447.64 / $20,199.53 / $25,548.75
| Facility | | $10,447.64 | $20,199.53 | $25,548.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,282.95 / $13,954.10 / $22,313.20
| Facility | | $9,282.95 | $13,954.10 | $22,313.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,217.61 / $18,564.43 / $28,204.76
| Facility | | $12,217.61 | $18,564.43 | $28,204.76 |