- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,322.20 / $17,122.80 / $22,977.50
| Facility | | $10,322.20 | $17,122.80 | $22,977.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,794.93 / $12,837.52 / $14,962.17
| Facility | | $11,794.93 | $12,837.52 | $14,962.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,464.45 / $14,394.82 / $23,029.32
| Facility | | $8,464.45 | $14,394.82 | $23,029.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,393.20 / $13,968.00 / $31,617.96
| Facility | | $9,393.20 | $13,968.00 | $31,617.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,063.23 / $13,580.62 / $19,578.66
| Facility | | $10,063.23 | $13,580.62 | $19,578.66 |