- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $15,488.17 / $26,915.35
| Facility | | $12,302.69 | $15,488.17 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $14,791.08 / $16,982.44
| Facility | | $14,791.08 | $14,791.08 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,488.17 / $25,118.86
| Facility | | $9,120.11 | $15,488.17 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $20,892.96 / $26,915.35
| Facility | | $13,182.57 | $20,892.96 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,417.38 / $31,622.78
| Facility | | $12,022.64 | $20,417.38 | $31,622.78 |