- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,291.70 / $17,913.30 / $29,709.80
| Facility | | $11,291.70 | $17,913.30 | $29,709.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,310.78 / $15,446.16 / $26,166.12
| Facility | | $10,310.78 | $15,446.16 | $26,166.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,424.85 / $19,086.98 / $27,444.75
| Facility | | $15,424.85 | $19,086.98 | $27,444.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,588.75 / $19,162.16 / $46,105.75
| Facility | | $9,588.75 | $19,162.16 | $46,105.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $18,754.06 / $26,490.00
| Facility | | $9,226.00 | $18,754.06 | $26,490.00 |