- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,527.00 / $24,778.10 / $35,083.10
| Facility | | $13,527.00 | $24,778.10 | $35,083.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,110.62 / $29,357.90 / $47,307.98
| Facility | | $18,110.62 | $29,357.90 | $47,307.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,063.94 / $25,793.00 / $39,656.05
| Facility | | $14,063.94 | $25,793.00 | $39,656.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,896.00 / $21,728.79 / $46,893.35
| Facility | | $7,896.00 | $21,728.79 | $46,893.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $19,900.48 / $41,671.87
| Facility | | $3,308.00 | $19,900.48 | $41,671.87 |