- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,893.36 / $18,122.20 / $25,659.10
| Facility | | $9,893.36 | $18,122.20 | $25,659.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,756.05 / $17,316.25 / $27,647.10
| Facility | | $10,756.05 | $17,316.25 | $27,647.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,286.10 / $16,301.91 / $29,003.69
| Facility | | $10,286.10 | $16,301.91 | $29,003.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,545.70 / $15,380.84 / $34,296.91
| Facility | | $6,545.70 | $15,380.84 | $34,296.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,045.76 / $30,478.03
| Facility | | $3,308.00 | $15,045.76 | $30,478.03 |