- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,332.10 / $19,130.40 / $33,664.10
| Facility | | $11,332.10 | $19,130.40 | $33,664.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,169.83 / $13,535.57 / $22,445.32
| Facility | | $9,169.83 | $13,535.57 | $22,445.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,308.31 / $17,633.59 / $24,348.84
| Facility | | $10,308.31 | $17,633.59 | $24,348.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,298.40 / $29,298.40 / $34,384.16
| Facility | | $29,298.40 | $29,298.40 | $34,384.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,672.02 / $23,814.07
| Facility | | $1,787.00 | $16,672.02 | $23,814.07 |