- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,434.70 / $24,639.40 / $40,049.40
| Facility | | $14,434.70 | $24,639.40 | $40,049.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.00 / $11,339.00 / $31,707.74
| Facility | | $11,339.00 | $11,339.00 | $31,707.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,377.63 / $19,577.23 / $30,884.98
| Facility | | $12,377.63 | $19,577.23 | $30,884.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,412.79 / $16,923.03 / $32,094.49
| Facility | | $9,412.79 | $16,923.03 | $32,094.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.00 / $20,447.33 / $28,125.72
| Facility | | $6,553.00 | $20,447.33 | $28,125.72 |