- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,620.80 / $16,947.00 / $27,510.30
| Facility | | $11,620.80 | $16,947.00 | $27,510.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,427.12 / $21,244.30 / $27,562.31
| Facility | | $10,427.12 | $21,244.30 | $27,562.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,258.90 / $28,801.06 / $36,924.43
| Facility | | $20,258.90 | $28,801.06 | $36,924.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,645.55 / $26,382.39 / $33,368.94
| Facility | | $13,645.55 | $26,382.39 | $33,368.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,124.40 / $18,225.30 / $29,143.00
| Facility | | $12,124.40 | $18,225.30 | $29,143.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,179.31 / $24,246.80 / $36,837.94
| Facility | | $14,179.31 | $24,246.80 | $36,837.94 |