- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,387.21 / $25,118.86
| Facility | | $16,218.10 | $22,387.21 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,892.96 / $27,542.29
| Facility | | $12,022.64 | $20,892.96 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $39,810.72
| Facility | | $10,715.19 | $16,218.10 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,848.93 / $23,442.29
| Facility | | $10,232.93 | $15,848.93 | $23,442.29 |