- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,060.90 / $24,442.60 / $44,527.90
| Facility | | $17,060.90 | $24,442.60 | $44,527.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $20,056.45 / $26,547.96
| Facility | | $11,258.00 | $20,056.45 | $26,547.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,761.77 / $21,766.46 / $34,338.69
| Facility | | $13,761.77 | $21,766.46 | $34,338.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,365.58 / $20,137.91 / $37,325.71
| Facility | | $11,365.58 | $20,137.91 | $37,325.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $22,733.86 / $31,270.89
| Facility | | $6,842.00 | $22,733.86 | $31,270.89 |