- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,212.60 / $15,008.90 / $23,172.40
| Facility | | $10,212.60 | $15,008.90 | $23,172.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,296.85 / $33,119.94 / $42,461.47
| Facility | | $23,296.85 | $33,119.94 | $42,461.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,493.88 / $22,222.34 / $28,107.24
| Facility | | $11,493.88 | $22,222.34 | $28,107.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,212.60 / $15,351.50 / $24,547.70
| Facility | | $10,212.60 | $15,351.50 | $24,547.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,943.48 / $20,423.50 / $31,029.23
| Facility | | $11,943.48 | $20,423.50 | $31,029.23 |