- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,397.40 / $19,045.50 / $26,966.40
| Facility | | $10,397.40 | $19,045.50 | $26,966.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,947.21 / $16,222.35 / $25,383.52
| Facility | | $9,947.21 | $16,222.35 | $25,383.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,810.14 / $17,132.43 / $30,481.32
| Facility | | $10,810.14 | $17,132.43 | $30,481.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,879.18 / $16,252.32 / $36,044.22
| Facility | | $6,879.18 | $16,252.32 | $36,044.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,812.29 / $32,030.77
| Facility | | $3,308.00 | $15,812.29 | $32,030.77 |