- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,301.60 / $20,998.30 / $34,131.10
| Facility | | $12,301.60 | $20,998.30 | $34,131.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $17,601.78 / $22,354.70
| Facility | | $11,231.00 | $17,601.78 | $22,354.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,548.53 / $16,684.20 / $26,320.94
| Facility | | $10,548.53 | $16,684.20 | $26,320.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,244.58 / $12,578.64 / $26,545.61
| Facility | | $6,244.58 | $12,578.64 | $26,545.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,669.54 / $23,969.43
| Facility | | $6,289.00 | $17,669.54 | $23,969.43 |