- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,440.10 / $16,705.90 / $21,957.30
| Facility | | $11,440.10 | $16,705.90 | $21,957.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,607.04 / $17,993.46 / $30,433.51
| Facility | | $6,607.04 | $17,993.46 | $30,433.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,621.53 / $16,780.12 / $28,086.13
| Facility | | $11,621.53 | $16,780.12 | $28,086.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,390.03 / $18,726.84 / $27,342.71
| Facility | | $14,390.03 | $18,726.84 | $27,342.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,390.03 / $17,409.09 / $27,342.71
| Facility | | $14,390.03 | $17,409.09 | $27,342.71 |