- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,674.80 / $19,553.59 / $27,685.90
| Facility | | $10,674.80 | $19,553.59 | $27,685.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,646.54 / $18,669.41 / $29,337.19
| Facility | | $11,646.54 | $18,669.41 | $29,337.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,098.56 / $17,589.54 / $31,294.58
| Facility | | $11,098.56 | $17,589.54 | $31,294.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,062.72 / $17,030.43 / $37,005.89
| Facility | | $7,062.72 | $17,030.43 | $37,005.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,234.17 / $32,885.37
| Facility | | $3,308.00 | $16,234.17 | $32,885.37 |