- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,198.50 / $20,513.00 / $29,044.10
| Facility | | $11,198.50 | $20,513.00 | $29,044.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,627.61 / $20,440.55 / $32,759.07
| Facility | | $12,627.61 | $20,440.55 | $32,759.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,643.06 / $18,452.49 / $32,829.90
| Facility | | $11,643.06 | $18,452.49 | $32,829.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,409.90 / $38,821.42
| Facility | | $7,117.00 | $17,409.90 | $38,821.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,030.62 / $34,498.74
| Facility | | $3,308.00 | $17,030.62 | $34,498.74 |