- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,800.30 / $21,615.30 / $30,604.90
| Facility | | $11,800.30 | $21,615.30 | $30,604.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,485.27 / $20,241.08 / $32,037.34
| Facility | | $12,485.27 | $20,241.08 | $32,037.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,268.74 / $19,444.09 / $34,594.12
| Facility | | $12,268.74 | $19,444.09 | $34,594.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,945.82 / $40,907.62
| Facility | | $7,117.00 | $17,945.82 | $40,907.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,945.82 / $36,352.65
| Facility | | $3,308.00 | $17,945.82 | $36,352.65 |