- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,509.80 / $16,978.30 / $23,493.50
| Facility | | $10,509.80 | $16,978.30 | $23,493.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,989.54 / $19,989.54 / $22,559.20
| Facility | | $19,989.54 | $19,989.54 | $22,559.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,409.23 / $15,076.96 / $22,841.92
| Facility | | $9,409.23 | $15,076.96 | $22,841.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,141.04 / $15,698.73 / $24,317.38
| Facility | | $10,141.04 | $15,698.73 | $24,317.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,229.64 / $15,087.14 / $23,012.65
| Facility | | $9,229.64 | $15,087.14 | $23,012.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,541.35 / $17,925.64 / $26,113.78
| Facility | | $9,541.35 | $17,925.64 | $26,113.78 |