- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,076.80 / $17,554.30 / $29,144.30
| Facility | | $11,076.80 | $17,554.30 | $29,144.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,171.68 / $15,237.78 / $25,813.12
| Facility | | $10,171.68 | $15,237.78 | $25,813.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,131.27 / $18,723.71 / $26,922.40
| Facility | | $15,131.27 | $18,723.71 | $26,922.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,046.56 / $17,986.25 / $45,483.75
| Facility | | $9,046.56 | $17,986.25 | $45,483.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $17,947.13 / $25,223.80
| Facility | | $9,226.00 | $17,947.13 | $25,223.80 |