- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,616.50 / $15,387.70 / $26,922.60
| Facility | | $11,616.50 | $15,387.70 | $26,922.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,899.87 / $12,050.59 / $19,396.09
| Facility | | $7,899.87 | $12,050.59 | $19,396.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $13,135.74 / $26,279.30
| Facility | | $5,843.91 | $13,135.74 | $26,279.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,657.95 / $15,628.55 / $24,037.20
| Facility | | $10,657.95 | $15,628.55 | $24,037.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,022.22 / $24,220.76
| Facility | | $3,496.00 | $17,022.22 | $24,220.76 |