- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,660.80 / $21,276.50 / $29,887.80
| Facility | | $15,660.80 | $21,276.50 | $29,887.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,747.87 / $19,347.13 / $28,378.87
| Facility | | $12,747.87 | $19,347.13 | $28,378.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,662.03 / $18,861.25 / $34,138.00
| Facility | | $13,662.03 | $18,861.25 | $34,138.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.38 / $200.03 / $318.80
| Facility | | $136.38 | $200.03 | $318.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,207.02 / $21,293.58 / $35,343.07
| Facility | | $16,207.02 | $21,293.58 | $35,343.07 |