- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,578.10 / $15,546.20 / $24,001.90
| Facility | | $10,578.10 | $15,546.20 | $24,001.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,320.41 / $27,466.84 / $35,213.90
| Facility | | $19,320.41 | $27,466.84 | $35,213.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,104.78 / $17,837.77 / $26,605.90
| Facility | | $9,104.78 | $17,837.77 | $26,605.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,578.10 / $15,901.00 / $25,426.40
| Facility | | $10,578.10 | $15,901.00 | $25,426.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,371.03 / $20,201.56 / $31,769.93
| Facility | | $12,371.03 | $20,201.56 | $31,769.93 |