- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,422.50 / $22,911.60 / $37,241.00
| Facility | | $13,422.50 | $22,911.60 | $37,241.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,208.75 / $15,937.12 / $22,617.00
| Facility | | $13,208.75 | $15,937.12 | $22,617.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,509.67 / $18,204.41 / $28,719.21
| Facility | | $11,509.67 | $18,204.41 | $28,719.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,612.64 / $19,186.41 / $35,471.11
| Facility | | $10,612.64 | $19,186.41 | $35,471.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,414.42 / $19,013.49 / $26,153.45
| Facility | | $6,414.42 | $19,013.49 | $26,153.45 |