- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $14,791.08 / $25,703.96
| Facility | | $11,748.98 | $14,791.08 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,803.84 / $14,125.38
| Facility | | $13,489.63 | $13,803.84 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $14,791.08 / $22,387.21
| Facility | | $8,709.64 | $14,791.08 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,952.62 / $25,118.86
| Facility | | $12,589.25 | $19,952.62 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $18,197.01 / $28,183.83
| Facility | | $11,481.54 | $18,197.01 | $28,183.83 |