- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,029.60 / $20,203.70 / $28,606.20
| Facility | | $11,029.60 | $20,203.70 | $28,606.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,290.21 / $21,419.77 / $34,160.83
| Facility | | $13,290.21 | $21,419.77 | $34,160.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,467.50 / $18,174.25 / $32,334.88
| Facility | | $11,467.50 | $18,174.25 | $32,334.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,147.39 / $38,236.05
| Facility | | $7,117.00 | $17,147.39 | $38,236.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,773.83 / $33,978.55
| Facility | | $3,308.00 | $16,773.83 | $33,978.55 |