- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,001.70 / $14,573.30 / $25,497.80
| Facility | | $11,001.70 | $14,573.30 | $25,497.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,052.24 / $11,477.00 / $19,251.72
| Facility | | $8,052.24 | $11,477.00 | $19,251.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,932.61 / $24,259.49
| Facility | | $5,843.91 | $11,932.61 | $24,259.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,152.34 / $14,801.42 / $22,765.05
| Facility | | $10,152.34 | $14,801.42 | $22,765.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $15,018.49 / $22,938.89
| Facility | | $3,496.00 | $15,018.49 | $22,938.89 |