- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,684.50 / $12,763.20 / $19,705.20
| Facility | | $8,684.50 | $12,763.20 | $19,705.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,183.39 / $34,380.29 / $44,077.30
| Facility | | $24,183.39 | $34,380.29 | $44,077.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,774.10 / $18,897.30 / $23,901.67
| Facility | | $9,774.10 | $18,897.30 | $23,901.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,684.50 / $13,054.50 / $20,874.70
| Facility | | $8,684.50 | $13,054.50 | $20,874.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,429.96 / $17,367.61 / $26,386.45
| Facility | | $11,429.96 | $17,367.61 | $26,386.45 |