- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,211.20 / $17,430.20 / $28,331.30
| Facility | | $10,211.20 | $17,430.20 | $28,331.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,674.47 / $15,582.49 / $18,969.63
| Facility | | $10,674.47 | $15,582.49 | $18,969.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,723.45 / $13,849.13 / $21,848.34
| Facility | | $8,723.45 | $13,849.13 | $21,848.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,111.74 / $11,756.50 / $22,034.83
| Facility | | $6,111.74 | $11,756.50 | $22,034.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $14,455.45 / $20,013.50
| Facility | | $6,164.00 | $14,455.45 | $20,013.50 |