- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,353.60 / $18,965.30 / $26,852.80
| Facility | | $10,353.60 | $18,965.30 | $26,852.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,633.00 / $18,862.45 / $30,269.27
| Facility | | $11,633.00 | $18,862.45 | $30,269.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,764.60 / $17,060.25 / $30,352.91
| Facility | | $10,764.60 | $17,060.25 | $30,352.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,197.80 / $15,745.67 / $35,892.37
| Facility | | $6,197.80 | $15,745.67 | $35,892.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,231.91 / $33,132.18
| Facility | | $3,308.00 | $15,231.91 | $33,132.18 |