- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,192.81 / $13,510.20 / $20,858.59
| Facility | | $9,192.81 | $13,510.20 | $20,858.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,557.27 / $26,381.92 / $33,822.98
| Facility | | $18,557.27 | $26,381.92 | $33,822.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,143.36 / $19,271.13 / $25,300.65
| Facility | | $1,143.36 | $19,271.13 | $25,300.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,192.81 / $13,818.60 / $22,096.50
| Facility | | $9,192.81 | $13,818.60 | $22,096.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,525.87 / $18,384.15 / $27,930.87
| Facility | | $11,525.87 | $18,384.15 | $27,930.87 |