- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,182.79 / $18,652.50 / $26,409.90
| Facility | | $10,182.79 | $18,652.50 | $26,409.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,446.16 / $19,565.97 / $20,461.66
| Facility | | $18,446.16 | $19,565.97 | $20,461.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,524.33 / $18,690.57 / $30,060.73
| Facility | | $11,524.33 | $18,690.57 | $30,060.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,587.06 / $16,050.62 / $29,852.30
| Facility | | $10,587.06 | $16,050.62 | $29,852.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,578.00 / $16,086.70 / $32,585.74
| Facility | | $6,578.00 | $16,086.70 | $32,585.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,485.98 / $31,369.78
| Facility | | $3,308.00 | $15,485.98 | $31,369.78 |