- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,529.90 / $24,802.00 / $40,313.60
| Facility | | $14,529.90 | $24,802.00 | $40,313.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $20,904.27 / $25,501.68
| Facility | | $11,258.00 | $20,904.27 | $25,501.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,459.30 / $19,706.40 / $31,088.75
| Facility | | $12,459.30 | $19,706.40 | $31,088.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,045.11 / $14,224.07 / $31,354.12
| Facility | | $7,045.11 | $14,224.07 | $31,354.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,783.00 / $20,582.24 / $28,311.29
| Facility | | $6,783.00 | $20,582.24 | $28,311.29 |