- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,756.80 / $19,749.70 / $26,502.50
| Facility | | $10,756.80 | $19,749.70 | $26,502.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,718.24 / $14,884.07 / $17,251.31
| Facility | | $13,718.24 | $14,884.07 | $17,251.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,081.70 / $16,816.82 / $26,165.28
| Facility | | $9,081.70 | $16,816.82 | $26,165.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,776.24 / $15,901.50 / $36,468.50
| Facility | | $9,776.24 | $15,901.50 | $36,468.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,422.00 / $15,435.06 / $22,004.50
| Facility | | $10,422.00 | $15,435.06 | $22,004.50 |