- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $20,417.38 / $28,183.83
| Facility | | $10,964.78 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,218.10 / $26,302.68
| Facility | | $11,220.18 | $16,218.10 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $21,877.62 / $30,199.52
| Facility | | $10,715.19 | $21,877.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $16,218.10 / $32,359.37
| Facility | | $6,760.83 | $16,218.10 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $15,848.93 / $31,622.78
| Facility | | $6,165.95 | $15,848.93 | $31,622.78 |