- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,140.40 / $16,081.70 / $28,136.80
| Facility | | $12,140.40 | $16,081.70 | $28,136.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,202.68 / $14,214.30 / $25,631.48
| Facility | | $9,202.68 | $14,214.30 | $25,631.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,174.18 / $27,725.52
| Facility | | $5,939.30 | $14,174.18 | $27,725.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,138.61 / $16,333.38 / $25,121.25
| Facility | | $11,138.61 | $16,333.38 | $25,121.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,789.91 / $25,313.09
| Facility | | $3,496.00 | $17,789.91 | $25,313.09 |