- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,861.66 / $13,023.50 / $20,107.20
| Facility | | $8,861.66 | $13,023.50 | $20,107.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,160.49 / $21,552.90 / $27,631.92
| Facility | | $15,160.49 | $21,552.90 | $27,631.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,973.48 / $19,282.79 / $24,389.25
| Facility | | $9,973.48 | $19,282.79 | $24,389.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,861.66 / $13,320.80 / $21,300.50
| Facility | | $8,861.66 | $13,320.80 | $21,300.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,363.61 / $17,721.90 / $26,924.71
| Facility | | $10,363.61 | $17,721.90 | $26,924.71 |