- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,236.80 / $24,246.70 / $34,330.69
| Facility | | $13,236.80 | $24,246.70 | $34,330.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,117.12 / $22,675.73 / $35,680.31
| Facility | | $14,117.12 | $22,675.73 | $35,680.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,373.00 / $20,864.50 / $38,805.57
| Facility | | $10,373.00 | $20,864.50 | $38,805.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $20,930.13 / $45,887.66
| Facility | | $7,117.00 | $20,930.13 | $45,887.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $20,130.52 / $40,778.17
| Facility | | $3,308.00 | $20,130.52 | $40,778.17 |