- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $21,379.62 / $28,840.32
| Facility | | $11,220.18 | $21,379.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $18,197.01 / $29,512.09
| Facility | | $12,302.69 | $18,197.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $22,908.68 / $30,902.95
| Facility | | $10,964.78 | $22,908.68 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $16,218.10 / $33,884.42
| Facility | | $6,918.31 | $16,218.10 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $16,218.10 / $32,359.37
| Facility | | $6,309.57 | $16,218.10 | $32,359.37 |