- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,187.40 / $14,876.70 / $21,534.50
| Facility | | $10,187.40 | $14,876.70 | $21,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,674.55 / $12,730.57 / $21,532.04
| Facility | | $4,674.55 | $12,730.57 | $21,532.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,349.03 / $14,942.79 / $25,010.85
| Facility | | $10,349.03 | $14,942.79 | $25,010.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,814.40 / $16,676.34 / $24,348.83
| Facility | | $12,814.40 | $16,676.34 | $24,348.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,814.40 / $15,502.89 / $24,348.83
| Facility | | $12,814.40 | $15,502.89 | $24,348.83 |