- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,250.30 / $16,428.80 / $21,593.10
| Facility | | $11,250.30 | $16,428.80 | $21,593.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,976.64 / $16,276.63 / $27,529.73
| Facility | | $5,976.64 | $16,276.63 | $27,529.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,428.79 / $16,501.84 / $27,620.35
| Facility | | $11,428.79 | $16,501.84 | $27,620.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,151.38 / $18,416.27 / $26,889.25
| Facility | | $14,151.38 | $18,416.27 | $26,889.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,151.38 / $17,120.38 / $26,889.25
| Facility | | $14,151.38 | $17,120.38 | $26,889.25 |