- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,910.73 / $15,739.40 / $26,131.10
| Facility | | $10,910.73 | $15,739.40 | $26,131.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,868.42 / $13,104.32 / $22,148.24
| Facility | | $8,868.42 | $13,104.32 | $22,148.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,566.87 / $16,811.00 / $24,797.00
| Facility | | $13,566.87 | $16,811.00 | $24,797.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,433.75 / $16,126.68 / $38,277.87
| Facility | | $8,433.75 | $16,126.68 | $38,277.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,433.75 / $16,091.60 / $22,615.94
| Facility | | $8,433.75 | $16,091.60 | $22,615.94 |