- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,140.40 / $29,258.00 / $47,556.50
| Facility | | $17,140.40 | $29,258.00 | $47,556.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $28,334.37 / $31,558.37
| Facility | | $11,258.00 | $28,334.37 | $31,558.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,697.79 / $23,246.93 / $36,674.28
| Facility | | $14,697.79 | $23,246.93 | $36,674.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,610.75 / $30,701.11 / $59,893.13
| Facility | | $14,610.75 | $30,701.11 | $59,893.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,759.30 / $24,280.12 / $33,397.81
| Facility | | $6,759.30 | $24,280.12 | $33,397.81 |