- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,148.60 / $21,241.20 / $29,392.40
| Facility | | $13,148.60 | $21,241.20 | $29,392.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,717.52 / $17,717.52 / $17,717.52
| Facility | | $17,717.52 | $17,717.52 | $17,717.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,072.69 / $20,169.59 / $30,557.37
| Facility | | $12,072.69 | $20,169.59 | $30,557.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,687.30 / $19,640.43 / $30,423.08
| Facility | | $12,687.30 | $19,640.43 | $30,423.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,547.06 / $18,875.27 / $28,790.76
| Facility | | $11,547.06 | $18,875.27 | $28,790.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,924.48 / $22,869.07 / $32,670.53
| Facility | | $9,924.48 | $22,869.07 | $32,670.53 |