- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,574.10 / $23,032.70 / $32,611.90
| Facility | | $12,574.10 | $23,032.70 | $32,611.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,662.38 / $20,314.99 / $31,933.14
| Facility | | $12,662.38 | $20,314.99 | $31,933.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,073.28 / $19,819.88 / $36,862.69
| Facility | | $13,073.28 | $19,819.88 | $36,862.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $19,162.91 / $40,238.03
| Facility | | $7,117.00 | $19,162.91 | $40,238.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $19,096.00 / $38,736.51
| Facility | | $3,308.00 | $19,096.00 | $38,736.51 |