- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,538.50 / $19,478.90 / $34,277.30
| Facility | | $11,538.50 | $19,478.90 | $34,277.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,941.36 / $16,150.52 / $26,104.62
| Facility | | $10,941.36 | $16,150.52 | $26,104.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,496.08 / $17,954.80 / $24,792.36
| Facility | | $10,496.08 | $17,954.80 | $24,792.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,501.30 / $33,501.30 / $39,316.62
| Facility | | $33,501.30 | $33,501.30 | $39,316.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,975.71 / $24,247.85
| Facility | | $1,787.00 | $16,975.71 | $24,247.85 |