- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,295.90 / $16,287.60 / $28,497.20
| Facility | | $12,295.90 | $16,287.60 | $28,497.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,020.95 / $15,510.06 / $22,076.99
| Facility | | $10,020.95 | $15,510.06 | $22,076.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,906.41 / $28,840.08
| Facility | | $5,939.30 | $14,906.41 | $28,840.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,281.27 / $16,542.58 / $25,443.00
| Facility | | $11,281.27 | $16,542.58 | $25,443.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,500.00 / $7,727.26 / $19,646.68
| Facility | | $3,500.00 | $7,727.26 | $19,646.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,785.18 / $25,637.29
| Facility | | $3,496.00 | $16,785.18 | $25,637.29 |