- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,791.08 / $25,703.96
| Facility | | $12,022.64 | $14,791.08 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $16,595.87 / $16,595.87
| Facility | | $16,595.87 | $16,595.87 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $15,135.61 / $24,547.09
| Facility | | $8,912.51 | $15,135.61 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,952.62 / $26,302.68
| Facility | | $12,882.50 | $19,952.62 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $19,498.45 / $30,199.52
| Facility | | $11,748.98 | $19,498.45 | $30,199.52 |