- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,914.94 / $18,161.80 / $25,715.10
| Facility | | $9,914.94 | $18,161.80 | $25,715.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,806.36 / $17,291.95 / $27,197.97
| Facility | | $10,806.36 | $17,291.95 | $27,197.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,308.54 / $15,628.37 / $29,066.96
| Facility | | $10,308.54 | $15,628.37 | $29,066.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,559.98 / $15,875.13 / $34,371.73
| Facility | | $6,559.98 | $15,875.13 | $34,371.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,078.58 / $30,544.52
| Facility | | $3,308.00 | $15,078.58 | $30,544.52 |