- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,498.45 / $25,118.86
| Facility | | $13,803.84 | $19,498.45 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,982.44 / $23,442.29
| Facility | | $10,964.78 | $16,982.44 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $20,417.38 / $28,183.83
| Facility | | $10,715.19 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,982.44 / $21,379.62
| Facility | | $10,964.78 | $16,982.44 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $20,417.38 / $28,183.83
| Facility | | $10,232.93 | $20,417.38 | $28,183.83 |