- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,935.90 / $15,810.70 / $27,662.80
| Facility | | $11,935.90 | $15,810.70 | $27,662.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,105.31 / $12,849.10 / $19,341.70
| Facility | | $10,105.31 | $12,849.10 | $19,341.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,049.32 / $27,181.83
| Facility | | $5,939.30 | $14,049.32 | $27,181.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,950.95 / $16,058.21 / $24,698.03
| Facility | | $10,950.95 | $16,058.21 | $24,698.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,490.18 / $24,886.63
| Facility | | $3,496.00 | $17,490.18 | $24,886.63 |