- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,633.20 / $16,734.40 / $29,278.90
| Facility | | $12,633.20 | $16,734.40 | $29,278.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,652.95 / $13,669.22 / $23,297.53
| Facility | | $9,652.95 | $13,669.22 | $23,297.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,225.64 / $29,082.03
| Facility | | $5,939.30 | $14,225.64 | $29,082.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,590.74 / $16,996.37 / $26,140.95
| Facility | | $11,590.74 | $16,996.37 | $26,140.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,245.63 / $26,340.57
| Facility | | $3,496.00 | $17,245.63 | $26,340.57 |