- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,682.60 / $17,736.20 / $25,112.50
| Facility | | $9,682.60 | $17,736.20 | $25,112.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,480.21 / $18,616.91 / $30,690.63
| Facility | | $11,480.21 | $18,616.91 | $30,690.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,066.98 / $15,954.64 / $28,385.83
| Facility | | $10,066.98 | $15,954.64 | $28,385.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,406.26 / $15,169.42 / $33,566.30
| Facility | | $6,406.26 | $15,169.42 | $33,566.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,725.25 / $29,828.77
| Facility | | $3,308.00 | $14,725.25 | $29,828.77 |