- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,943.20 / $16,982.40 / $27,186.30
| Facility | | $10,943.20 | $16,982.40 | $27,186.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,700.05 / $11,700.05 / $16,893.36
| Facility | | $11,700.05 | $11,700.05 | $16,893.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,882.07 / $13,490.40 / $18,998.95
| Facility | | $6,882.07 | $13,490.40 | $18,998.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,112.23 / $13,547.41 / $23,736.86
| Facility | | $10,112.23 | $13,547.41 | $23,736.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,929.39 / $15,342.57 / $20,559.50
| Facility | | $9,929.39 | $15,342.57 | $20,559.50 |