- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,433.60 / $19,111.80 / $27,060.20
| Facility | | $10,433.60 | $19,111.80 | $27,060.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,890.70 / $19,284.75 / $31,016.39
| Facility | | $11,890.70 | $19,284.75 | $31,016.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,847.76 / $17,192.06 / $30,587.40
| Facility | | $10,847.76 | $17,192.06 | $30,587.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,903.12 / $16,677.61 / $36,169.65
| Facility | | $6,903.12 | $16,677.61 | $36,169.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,555.64 / $32,142.24
| Facility | | $3,308.00 | $14,555.64 | $32,142.24 |