- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,835.40 / $19,847.80 / $28,102.40
| Facility | | $10,835.40 | $19,847.80 | $28,102.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,746.23 / $19,060.73 / $30,729.88
| Facility | | $11,746.23 | $19,060.73 | $30,729.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,265.54 / $22,804.18 / $31,765.41
| Facility | | $11,265.54 | $22,804.18 | $31,765.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $16,472.78 / $37,562.66
| Facility | | $7,117.00 | $16,472.78 | $37,562.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,478.41 / $34,674.01
| Facility | | $3,308.00 | $16,478.41 | $34,674.01 |