- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,010.30 / $17,538.70 / $23,051.80
| Facility | | $12,010.30 | $17,538.70 | $23,051.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,759.92 / $13,068.59 / $21,925.26
| Facility | | $4,759.92 | $13,068.59 | $21,925.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,200.86 / $17,616.61 / $29,486.22
| Facility | | $12,200.86 | $17,616.61 | $29,486.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,107.37 / $19,660.37 / $28,705.74
| Facility | | $15,107.37 | $19,660.37 | $28,705.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,017.45 / $16,788.49 / $26,800.54
| Facility | | $10,017.45 | $16,788.49 | $26,800.54 |