- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,128.50 / $16,065.80 / $28,109.10
| Facility | | $12,128.50 | $16,065.80 | $28,109.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,378.45 / $11,231.46 / $13,006.37
| Facility | | $10,378.45 | $11,231.46 | $13,006.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $13,994.25 / $27,622.22
| Facility | | $5,939.30 | $13,994.25 | $27,622.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,127.64 / $16,317.29 / $25,096.50
| Facility | | $11,127.64 | $16,317.29 | $25,096.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,556.59 / $25,288.15
| Facility | | $3,496.00 | $16,556.59 | $25,288.15 |