- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,178.20 / $16,323.50 / $21,454.70
| Facility | | $11,178.20 | $16,323.50 | $21,454.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,917.32 / $12,917.32 / $12,917.32
| Facility | | $12,917.32 | $12,917.32 | $12,917.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,872.49 / $13,269.63 / $22,443.79
| Facility | | $4,872.49 | $13,269.63 | $22,443.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,355.53 / $16,396.06 / $27,443.29
| Facility | | $11,355.53 | $16,396.06 | $27,443.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,060.67 / $18,298.22 / $26,716.89
| Facility | | $14,060.67 | $18,298.22 | $26,716.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,060.67 / $17,010.63 / $26,716.89
| Facility | | $14,060.67 | $17,010.63 | $26,716.89 |