- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,913.30 / $37,405.10 / $60,799.10
| Facility | | $21,913.30 | $37,405.10 | $60,799.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $31,111.18 / $41,452.87
| Facility | | $11,258.00 | $31,111.18 | $41,452.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,790.50 / $29,720.23 / $46,886.54
| Facility | | $18,790.50 | $29,720.23 | $46,886.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,181.01 / $24,199.73 / $47,286.76
| Facility | | $12,181.01 | $24,199.73 | $47,286.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $31,041.13 / $42,697.71
| Facility | | $6,842.00 | $31,041.13 | $42,697.71 |