- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,719.54 / $12,814.70 / $19,784.80
| Facility | | $8,719.54 | $12,814.70 | $19,784.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,910.44 / $21,197.41 / $27,176.17
| Facility | | $14,910.44 | $21,197.41 | $27,176.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.42 / $18,279.03 / $23,998.15
| Facility | | $45.42 | $18,279.03 | $23,998.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,719.54 / $13,107.20 / $20,959.00
| Facility | | $8,719.54 | $13,107.20 | $20,959.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,197.42 / $17,437.72 / $26,492.96
| Facility | | $10,197.42 | $17,437.72 | $26,492.96 |