- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,172.30 / $22,296.70 / $31,569.70
| Facility | | $12,172.30 | $22,296.70 | $31,569.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,486.06 / $18,624.20 / $29,926.54
| Facility | | $11,486.06 | $18,624.20 | $29,926.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,655.50 / $20,057.05 / $35,684.68
| Facility | | $12,655.50 | $20,057.05 | $35,684.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,233.24 / $42,197.20
| Facility | | $7,117.00 | $18,233.24 | $42,197.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,511.55 / $37,498.62
| Facility | | $3,308.00 | $18,511.55 | $37,498.62 |