- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,286.08 / $13,647.30 / $21,070.20
| Facility | | $9,286.08 | $13,647.30 | $21,070.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,310.46 / $26,031.06 / $33,373.15
| Facility | | $18,310.46 | $26,031.06 | $33,373.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,451.16 / $20,206.34 / $25,557.37
| Facility | | $10,451.16 | $20,206.34 | $25,557.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,286.08 / $13,958.80 / $22,320.70
| Facility | | $9,286.08 | $13,958.80 | $22,320.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,859.97 / $18,570.68 / $28,214.27
| Facility | | $10,859.97 | $18,570.68 | $28,214.27 |