- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,086.20 / $16,426.00 / $29,664.20
| Facility | | $11,086.20 | $16,426.00 | $29,664.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,130.20 / $14,231.13 / $22,200.87
| Facility | | $11,130.20 | $14,231.13 | $22,200.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $15,457.10 / $30,362.65
| Facility | | $5,843.91 | $15,457.10 | $30,362.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,353.21 / $16,260.17 / $26,484.98
| Facility | | $10,353.21 | $16,260.17 | $26,484.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $19,311.02 / $28,332.20
| Facility | | $3,496.00 | $19,311.02 | $28,332.20 |