- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,462.00 / $28,134.30 / $51,985.70
| Facility | | $9,462.00 | $28,134.30 | $51,985.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $24,364.22 / $31,787.26
| Facility | | $11,231.00 | $24,364.22 | $31,787.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,732.37 / $26,712.00 / $44,377.43
| Facility | | $16,732.37 | $26,712.00 | $44,377.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,333.59 / $27,062.77 / $50,245.22
| Facility | | $15,333.59 | $27,062.77 | $50,245.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,590.00 / $25,621.00 / $37,641.81
| Facility | | $8,590.00 | $25,621.00 | $37,641.81 |