- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,925.10 / $18,180.40 / $25,741.50
| Facility | | $9,925.10 | $18,180.40 | $25,741.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,468.87 / $16,795.82 / $26,416.85
| Facility | | $10,468.87 | $16,795.82 | $26,416.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,319.10 / $16,354.21 / $29,096.74
| Facility | | $10,319.10 | $16,354.21 | $29,096.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,566.70 / $15,430.18 / $34,406.94
| Facility | | $6,566.70 | $15,430.18 | $34,406.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,094.03 / $30,575.81
| Facility | | $3,308.00 | $15,094.03 | $30,575.81 |