- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,642.20 / $18,165.90 / $29,527.20
| Facility | | $10,642.20 | $18,165.90 | $29,527.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,177.00 / $13,477.00 / $17,871.33
| Facility | | $11,177.00 | $13,477.00 | $17,871.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,125.65 / $14,433.70 / $22,770.55
| Facility | | $9,125.65 | $14,433.70 | $22,770.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,818.53 / $12,669.12 / $22,991.06
| Facility | | $6,818.53 | $12,669.12 | $22,991.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $15,286.12 / $20,736.24
| Facility | | $6,289.00 | $15,286.12 | $20,736.24 |