- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,740.20 / $21,507.60 / $37,847.19
| Facility | | $12,740.20 | $21,507.60 | $37,847.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,976.10 / $18,479.34 / $30,569.90
| Facility | | $12,976.10 | $18,479.34 | $30,569.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,589.25 / $19,641.37 / $27,374.49
| Facility | | $11,589.25 | $19,641.37 | $27,374.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,869.25 / $39,869.25 / $46,789.95
| Facility | | $39,869.25 | $39,869.25 | $46,789.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,743.73 / $26,773.27
| Facility | | $1,787.00 | $18,743.73 | $26,773.27 |