- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,673.90 / $15,463.70 / $27,055.70
| Facility | | $11,673.90 | $15,463.70 | $27,055.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,133.63 / $12,577.75 / $18,751.38
| Facility | | $11,133.63 | $12,577.75 | $18,751.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $15,780.68 / $26,969.79
| Facility | | $5,939.30 | $15,780.68 | $26,969.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,710.62 / $15,705.79 / $24,156.00
| Facility | | $10,710.62 | $15,705.79 | $24,156.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $15,936.13 / $24,340.46
| Facility | | $3,496.00 | $15,936.13 | $24,340.46 |