- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,337.91 / $17,104.80 / $24,218.50
| Facility | | $9,337.91 | $17,104.80 | $24,218.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,486.95 / $15,351.19 / $25,291.85
| Facility | | $9,486.95 | $15,351.19 | $25,291.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,708.60 / $15,386.66 / $27,375.31
| Facility | | $9,708.60 | $15,386.66 | $27,375.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.20 / $13,908.16 / $32,371.36
| Facility | | $6,178.20 | $13,908.16 | $32,371.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,201.03 / $28,766.88
| Facility | | $3,308.00 | $14,201.03 | $28,766.88 |