- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,084.20 / $16,007.20 / $28,006.50
| Facility | | $12,084.20 | $16,007.20 | $28,006.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,577.89 / $12,993.30 / $22,335.83
| Facility | | $9,577.89 | $12,993.30 | $22,335.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,113.09 / $27,643.96
| Facility | | $5,939.30 | $14,113.09 | $27,643.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,428.73 / $17,205.41 / $26,333.00
| Facility | | $11,428.73 | $17,205.41 | $26,333.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,496.18 / $25,195.87
| Facility | | $3,496.00 | $16,496.18 | $25,195.87 |