- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,621.20 / $16,832.30 / $27,945.60
| Facility | | $10,621.20 | $16,832.30 | $27,945.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,440.15 / $13,055.98 / $13,987.56
| Facility | | $10,440.15 | $13,055.98 | $13,987.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,009.62 / $14,995.02 / $25,401.88
| Facility | | $10,009.62 | $14,995.02 | $25,401.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,474.00 / $17,953.61 / $25,815.10
| Facility | | $14,474.00 | $17,953.61 | $25,815.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $17,246.49 / $44,759.12
| Facility | | $8,787.00 | $17,246.49 | $44,759.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,019.37 / $17,208.97 / $24,186.36
| Facility | | $9,019.37 | $17,208.97 | $24,186.36 |