- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,038.81 / $13,283.90 / $20,509.20
| Facility | | $9,038.81 | $13,283.90 | $20,509.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,580.83 / $20,728.82 / $26,575.41
| Facility | | $14,580.83 | $20,728.82 | $26,575.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,172.87 / $19,668.29 / $24,876.82
| Facility | | $10,172.87 | $19,668.29 | $24,876.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,038.81 / $13,587.10 / $21,726.40
| Facility | | $9,038.81 | $13,587.10 | $21,726.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,570.79 / $17,261.82 / $27,146.76
| Facility | | $10,570.79 | $17,261.82 | $27,146.76 |