- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,171.40 / $18,631.50 / $26,380.30
| Facility | | $10,171.40 | $18,631.50 | $26,380.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,215.48 / $17,805.86 / $28,159.36
| Facility | | $11,215.48 | $17,805.86 | $28,159.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,575.18 / $16,673.53 / $29,818.80
| Facility | | $10,575.18 | $16,673.53 | $29,818.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,729.66 / $15,813.10 / $35,260.79
| Facility | | $6,729.66 | $15,813.10 | $35,260.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,180.36 / $31,334.58
| Facility | | $3,308.00 | $14,180.36 | $31,334.58 |