- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,568.20 / $19,358.30 / $27,409.30
| Facility | | $10,568.20 | $19,358.30 | $27,409.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,630.87 / $18,810.88 / $29,895.71
| Facility | | $11,630.87 | $18,810.88 | $29,895.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,987.68 / $17,413.81 / $30,981.93
| Facility | | $10,987.68 | $17,413.81 | $30,981.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,992.16 / $16,892.73 / $36,636.19
| Facility | | $6,992.16 | $16,892.73 | $36,636.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,071.98 / $32,556.83
| Facility | | $3,308.00 | $16,071.98 | $32,556.83 |