- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,852.10 / $18,046.70 / $25,552.10
| Facility | | $9,852.10 | $18,046.70 | $25,552.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,315.81 / $16,372.35 / $25,883.25
| Facility | | $10,315.81 | $16,372.35 | $25,883.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,243.20 / $16,233.92 / $28,882.72
| Facility | | $10,243.20 | $16,233.92 | $28,882.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,518.40 / $15,316.69 / $34,153.87
| Facility | | $6,518.40 | $15,316.69 | $34,153.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,983.01 / $30,350.91
| Facility | | $3,308.00 | $14,983.01 | $30,350.91 |