- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,738.30 / $19,669.90 / $27,850.50
| Facility | | $10,738.30 | $19,669.90 | $27,850.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,488.12 / $18,220.61 / $19,665.33
| Facility | | $17,488.12 | $18,220.61 | $19,665.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,755.04 / $18,942.16 / $30,214.87
| Facility | | $11,755.04 | $18,942.16 | $30,214.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,164.56 / $17,694.14 / $31,480.68
| Facility | | $11,164.56 | $17,694.14 | $31,480.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,104.72 / $16,693.05 / $37,225.96
| Facility | | $7,104.72 | $16,693.05 | $37,225.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,330.71 / $33,080.93
| Facility | | $3,308.00 | $16,330.71 | $33,080.93 |