- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,346.60 / $18,952.50 / $26,834.70
| Facility | | $10,346.60 | $18,952.50 | $26,834.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,736.36 / $18,950.18 / $29,939.23
| Facility | | $11,736.36 | $18,950.18 | $29,939.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,757.34 / $15,288.00 / $30,332.44
| Facility | | $10,757.34 | $15,288.00 | $30,332.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,193.62 / $16,066.30 / $35,868.17
| Facility | | $6,193.62 | $16,066.30 | $35,868.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $15,735.05 / $30,078.19
| Facility | | $5,264.00 | $15,735.05 | $30,078.19 |