- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,335.80 / $16,470.09 / $26,388.50
| Facility | | $12,335.80 | $16,470.09 | $26,388.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,044.45 / $15,328.96 / $22,444.01
| Facility | | $10,044.45 | $15,328.96 | $22,444.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,761.38 / $14,856.73 / $26,890.00
| Facility | | $10,761.38 | $14,856.73 | $26,890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.39 / $157.56 / $251.11
| Facility | | $114.39 | $157.56 | $251.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,853.11 / $16,404.24 / $26,997.56
| Facility | | $11,853.11 | $16,404.24 | $26,997.56 |