- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,356.10 / $18,969.90 / $26,859.40
| Facility | | $10,356.10 | $18,969.90 | $26,859.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,090.66 / $16,090.66 / $18,679.41
| Facility | | $16,090.66 | $16,090.66 | $18,679.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,433.33 / $18,359.78 / $29,387.96
| Facility | | $11,433.33 | $18,359.78 | $29,387.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,767.24 / $17,064.43 / $30,360.35
| Facility | | $10,767.24 | $17,064.43 | $30,360.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,851.88 / $16,027.74 / $35,901.18
| Facility | | $6,851.88 | $16,027.74 | $35,901.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,749.54 / $31,903.66
| Facility | | $3,308.00 | $15,749.54 | $31,903.66 |