- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,851.90 / $19,878.09 / $28,145.20
| Facility | | $10,851.90 | $19,878.09 | $28,145.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,805.59 / $18,940.39 / $29,751.53
| Facility | | $11,805.59 | $18,940.39 | $29,751.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,282.70 / $17,881.37 / $31,813.80
| Facility | | $11,282.70 | $17,881.37 | $31,813.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,346.30 / $37,619.87
| Facility | | $7,117.00 | $17,346.30 | $37,619.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,503.50 / $33,430.98
| Facility | | $3,308.00 | $16,503.50 | $33,430.98 |