- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,898.20 / $19,962.90 / $28,265.40
| Facility | | $10,898.20 | $19,962.90 | $28,265.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,920.43 / $17,643.90 / $28,069.62
| Facility | | $10,920.43 | $17,643.90 | $28,069.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,330.88 / $17,957.73 / $31,949.65
| Facility | | $11,330.88 | $17,957.73 | $31,949.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $16,801.59 / $37,780.51
| Facility | | $7,117.00 | $16,801.59 | $37,780.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,573.99 / $33,573.74
| Facility | | $3,308.00 | $16,573.99 | $33,573.74 |