- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,054.61 / $31,622.78
| Facility | | $12,589.25 | $19,054.61 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,135.61 / $25,118.86
| Facility | | $10,964.78 | $15,135.61 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $14,125.38 / $18,620.87
| Facility | | $10,964.78 | $14,125.38 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $17,782.79 / $25,703.96
| Facility | | $11,220.18 | $17,782.79 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,595.87 / $22,387.21
| Facility | | $11,748.98 | $16,595.87 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $17,378.01 / $23,988.33
| Facility | | $5,888.44 | $17,378.01 | $23,988.33 |