- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.60 / $15,038.30 / $23,217.90
| Facility | | $10,232.60 | $15,038.30 | $23,217.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,405.47 / $20,479.52 / $26,255.80
| Facility | | $14,405.47 | $20,479.52 | $26,255.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,516.43 / $22,265.93 / $28,162.38
| Facility | | $11,516.43 | $22,265.93 | $28,162.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.60 / $15,381.60 / $24,595.80
| Facility | | $10,232.60 | $15,381.60 | $24,595.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,751.49 / $20,463.56 / $31,090.09
| Facility | | $12,751.49 | $20,463.56 | $31,090.09 |