- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,894.82 / $16,293.20 / $23,069.40
| Facility | | $8,894.82 | $16,293.20 | $23,069.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,863.05 / $17,428.21 / $27,399.89
| Facility | | $10,863.05 | $17,428.21 | $27,399.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,247.92 / $14,656.55 / $26,076.33
| Facility | | $9,247.92 | $14,656.55 | $26,076.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,885.04 / $14,288.04 / $30,835.31
| Facility | | $5,885.04 | $14,288.04 | $30,835.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $12,392.08 / $27,401.87
| Facility | | $3,308.00 | $12,392.08 | $27,401.87 |