- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $17,782.79 / $20,417.38
| Facility | | $11,220.18 | $17,782.79 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,054.61 / $25,118.86
| Facility | | $12,589.25 | $19,054.61 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $22,387.21
| Facility | | $10,715.19 | $16,218.10 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $18,197.01 / $20,892.96
| Facility | | $12,589.25 | $18,197.01 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $18,197.01 / $26,915.35
| Facility | | $4,073.80 | $18,197.01 | $26,915.35 |