- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,967.40 / $18,659.20 / $28,444.90
| Facility | | $10,967.40 | $18,659.20 | $28,444.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,314.93 / $21,589.64 / $34,645.01
| Facility | | $13,314.93 | $21,589.64 | $34,645.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,402.82 / $18,071.74 / $32,152.50
| Facility | | $11,402.82 | $18,071.74 | $32,152.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,223.50 / $38,020.39
| Facility | | $7,117.00 | $17,223.50 | $38,020.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,679.22 / $33,786.90
| Facility | | $3,308.00 | $16,679.22 | $33,786.90 |