- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,962.01 / $30,756.98 / $30,756.98
| Facility | | $26,962.01 | $30,756.98 | $30,756.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,901.07 / $13,548.24 / $24,763.43
| Facility | | $7,901.07 | $13,548.24 | $24,763.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,496.10 / $22,084.21 / $28,883.00
| Facility | | $13,496.10 | $22,084.21 | $28,883.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,313.06 / $15,470.44 / $22,727.85
| Facility | | $10,313.06 | $15,470.44 | $22,727.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,599.36 / $12,599.36 / $21,926.35
| Facility | | $12,599.36 | $12,599.36 | $21,926.35 |