- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,882.76 / $16,271.10 / $23,038.10
| Facility | | $8,882.76 | $16,271.10 | $23,038.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,666.10 / $17,113.25 / $26,916.93
| Facility | | $10,666.10 | $17,113.25 | $26,916.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,235.37 / $14,636.68 / $26,040.97
| Facility | | $9,235.37 | $14,636.68 | $26,040.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,877.06 / $14,042.42 / $30,793.50
| Facility | | $5,877.06 | $14,042.42 | $30,793.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,508.84 / $27,364.71
| Facility | | $3,308.00 | $13,508.84 | $27,364.71 |