- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,381.60 / $15,160.20 / $19,925.70
| Facility | | $10,381.60 | $15,160.20 | $19,925.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,724.11 / $12,827.03 / $16,819.40
| Facility | | $10,724.11 | $12,827.03 | $16,819.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.45 / $16,284.30 / $27,542.69
| Facility | | $5,979.45 | $16,284.30 | $27,542.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,546.27 / $15,227.58 / $25,487.53
| Facility | | $10,546.27 | $15,227.58 | $25,487.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,058.63 / $16,994.18 / $24,812.89
| Facility | | $13,058.63 | $16,994.18 | $24,812.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,058.63 / $15,798.36 / $24,812.89
| Facility | | $13,058.63 | $15,798.36 | $24,812.89 |