- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,050.70 / $15,962.80 / $27,928.90
| Facility | | $12,050.70 | $15,962.80 | $27,928.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,152.60 / $11,871.02 / $17,341.75
| Facility | | $7,152.60 | $11,871.02 | $17,341.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,921.56 / $13,105.99 / $26,793.09
| Facility | | $5,921.56 | $13,105.99 | $26,793.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,056.31 / $16,212.69 / $24,935.63
| Facility | | $11,056.31 | $16,212.69 | $24,935.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,450.46 / $25,126.04
| Facility | | $3,496.00 | $16,450.46 | $25,126.04 |