- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,449.40 / $19,140.90 / $27,101.40
| Facility | | $10,449.40 | $19,140.90 | $27,101.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,428.53 / $18,364.75 / $28,858.45
| Facility | | $11,428.53 | $18,364.75 | $28,858.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,864.26 / $17,218.21 / $30,633.92
| Facility | | $10,864.26 | $17,218.21 | $30,633.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,913.62 / $16,245.36 / $36,224.67
| Facility | | $6,913.62 | $16,245.36 | $36,224.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,891.45 / $32,191.13
| Facility | | $3,308.00 | $15,891.45 | $32,191.13 |