- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,874.20 / $15,981.30 / $24,673.80
| Facility | | $10,874.20 | $15,981.30 | $24,673.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,356.13 / $27,517.63 / $35,279.01
| Facility | | $19,356.13 | $27,517.63 | $35,279.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,238.58 / $23,662.15 / $29,928.34
| Facility | | $12,238.58 | $23,662.15 | $29,928.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,874.20 / $16,346.10 / $26,138.10
| Facility | | $10,874.20 | $16,346.10 | $26,138.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,717.31 / $21,746.75 / $33,039.64
| Facility | | $12,717.31 | $21,746.75 | $33,039.64 |