- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,152.40 / $18,596.70 / $26,330.90
| Facility | | $10,152.40 | $18,596.70 | $26,330.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,575.84 / $18,619.80 / $29,754.27
| Facility | | $11,575.84 | $18,619.80 | $29,754.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,555.38 / $16,728.68 / $29,762.97
| Facility | | $10,555.38 | $16,728.68 | $29,762.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,717.06 / $16,193.57 / $35,194.76
| Facility | | $6,717.06 | $16,193.57 | $35,194.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,439.64 / $31,275.91
| Facility | | $3,308.00 | $15,439.64 | $31,275.91 |