- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,768.40 / $16,913.50 / $29,592.20
| Facility | | $12,768.40 | $16,913.50 | $29,592.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,926.31 / $14,406.95 / $20,984.03
| Facility | | $11,926.31 | $14,406.95 | $20,984.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,435.82 / $29,103.77
| Facility | | $5,939.30 | $14,435.82 | $29,103.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,993.74 / $18,430.39 / $28,089.00
| Facility | | $11,993.74 | $18,430.39 | $28,089.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,613.00 / $26,622.38
| Facility | | $3,496.00 | $16,613.00 | $26,622.38 |