- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,197.40 / $18,679.20 / $26,447.80
| Facility | | $10,197.40 | $18,679.20 | $26,447.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,805.69 / $17,279.18 / $27,186.45
| Facility | | $10,805.69 | $17,279.18 | $27,186.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,602.24 / $16,802.93 / $29,895.10
| Facility | | $10,602.24 | $16,802.93 | $29,895.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.88 / $16,379.01 / $35,351.01
| Facility | | $6,746.88 | $16,379.01 | $35,351.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,508.19 / $31,414.76
| Facility | | $3,308.00 | $15,508.19 | $31,414.76 |