- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,485.80 / $16,880.20 / $26,061.50
| Facility | | $11,485.80 | $16,880.20 | $26,061.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,074.18 / $20,060.55 / $24,818.95
| Facility | | $18,074.18 | $20,060.55 | $24,818.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,090.24 / $29,982.93 / $38,439.65
| Facility | | $21,090.24 | $29,982.93 | $38,439.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,926.92 / $24,992.99 / $31,611.60
| Facility | | $12,926.92 | $24,992.99 | $31,611.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,485.80 / $17,265.50 / $27,608.20
| Facility | | $11,485.80 | $17,265.50 | $27,608.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,432.57 / $22,969.86 / $34,897.90
| Facility | | $13,432.57 | $22,969.86 | $34,897.90 |