- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,967.70 / $20,492.40 / $36,048.50
| Facility | | $10,967.70 | $20,492.40 | $36,048.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $14,208.75 / $24,320.93
| Facility | | $11,258.00 | $14,208.75 | $24,320.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,141.13 / $17,621.50 / $27,799.61
| Facility | | $11,141.13 | $17,621.50 | $27,799.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,867.15 / $15,998.74 / $28,783.24
| Facility | | $8,867.15 | $15,998.74 | $28,783.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $18,662.18 / $25,316.00
| Facility | | $6,289.00 | $18,662.18 | $25,316.00 |