- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,212.20 / $16,176.70 / $28,303.10
| Facility | | $12,212.20 | $16,176.70 | $28,303.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,124.50 / $18,345.89 / $23,420.35
| Facility | | $10,124.50 | $18,345.89 | $23,420.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,472.72 / $27,981.05
| Facility | | $5,939.30 | $14,472.72 | $27,981.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,204.45 / $16,429.93 / $25,269.75
| Facility | | $11,204.45 | $16,429.93 | $25,269.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,670.89 / $25,462.72
| Facility | | $3,496.00 | $16,670.89 | $25,462.72 |