- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,815.70 / $19,811.80 / $28,051.40
| Facility | | $10,815.70 | $19,811.80 | $28,051.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,527.48 / $18,601.25 / $29,387.96
| Facility | | $11,527.48 | $18,601.25 | $29,387.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,245.08 / $17,821.75 / $31,707.72
| Facility | | $11,245.08 | $17,821.75 | $31,707.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $16,814.80 / $37,494.44
| Facility | | $7,117.00 | $16,814.80 | $37,494.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,448.49 / $33,319.51
| Facility | | $3,308.00 | $16,448.49 | $33,319.51 |