- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,663.70 / $28,809.80 / $43,491.30
| Facility | | $16,663.70 | $28,809.80 | $43,491.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $19,286.81 / $25,268.71
| Facility | | $11,258.00 | $19,286.81 | $25,268.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,522.27 / $21,259.73 / $33,539.28
| Facility | | $13,522.27 | $21,259.73 | $33,539.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,547.53 / $19,117.07 / $34,613.92
| Facility | | $10,547.53 | $19,117.07 | $34,613.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,317.66 / $22,000.00 / $30,173.00
| Facility | | $7,317.66 | $22,000.00 | $30,173.00 |