- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,810.20 / $16,968.90 / $29,689.20
| Facility | | $12,810.20 | $16,968.90 | $29,689.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,330.00 / $20,263.02 / $23,913.82
| Facility | | $10,330.00 | $20,263.02 | $23,913.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $15,749.30 / $30,183.00
| Facility | | $5,939.30 | $15,749.30 | $30,183.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,753.15 / $17,234.53 / $26,507.25
| Facility | | $11,753.15 | $17,234.53 | $26,507.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,487.29 / $26,709.67
| Facility | | $3,496.00 | $17,487.29 | $26,709.67 |