- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,496.70 / $20,527.50 / $35,915.30
| Facility | | $15,496.70 | $20,527.50 | $35,915.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,904.72 / $16,865.09 / $27,824.15
| Facility | | $10,904.72 | $16,865.09 | $27,824.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $17,262.96 / $36,275.06
| Facility | | $5,939.30 | $17,262.96 | $36,275.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,134.00 / $19,694.41 / $32,066.10
| Facility | | $13,134.00 | $19,694.41 | $32,066.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $21,154.56 / $32,310.97
| Facility | | $3,496.00 | $21,154.56 | $32,310.97 |