- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,210.40 / $16,370.50 / $21,516.50
| Facility | | $11,210.40 | $16,370.50 | $21,516.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,019.82 / $21,840.99 / $36,941.08
| Facility | | $8,019.82 | $21,840.99 | $36,941.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,388.22 / $16,443.25 / $29,465.28
| Facility | | $11,388.22 | $16,443.25 | $29,465.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,101.14 / $18,350.88 / $26,793.79
| Facility | | $14,101.14 | $18,350.88 | $26,793.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,101.14 / $17,059.59 / $26,793.79
| Facility | | $14,101.14 | $17,059.59 | $26,793.79 |