- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,979.90 / $21,944.40 / $31,070.90
| Facility | | $11,979.90 | $21,944.40 | $31,070.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,763.81 / $18,645.71 / $29,597.03
| Facility | | $11,763.81 | $18,645.71 | $29,597.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,455.52 / $19,740.11 / $35,120.79
| Facility | | $12,455.52 | $19,740.11 | $35,120.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,257.90 / $41,530.40
| Facility | | $7,117.00 | $18,257.90 | $41,530.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,219.03 / $36,906.08
| Facility | | $3,308.00 | $18,219.03 | $36,906.08 |