- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,818.18 / $14,429.30 / $22,277.60
| Facility | | $9,818.18 | $14,429.30 | $22,277.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,396.84 / $19,171.50 / $28,051.73
| Facility | | $16,396.84 | $19,171.50 | $28,051.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,892.97 / $24,015.89 / $30,789.60
| Facility | | $16,892.97 | $24,015.89 | $30,789.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,050.02 / $21,364.18 / $27,021.82
| Facility | | $11,050.02 | $21,364.18 | $27,021.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,818.18 / $14,758.60 / $23,599.70
| Facility | | $9,818.18 | $14,758.60 | $23,599.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,482.26 / $19,634.80 / $29,830.97
| Facility | | $11,482.26 | $19,634.80 | $29,830.97 |