- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,229.00 / $20,568.80 / $29,123.20
| Facility | | $11,229.00 | $20,568.80 | $29,123.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,948.57 / $22,590.40 / $36,204.53
| Facility | | $13,948.57 | $22,590.40 | $36,204.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,674.74 / $18,502.68 / $32,919.23
| Facility | | $11,674.74 | $18,502.68 | $32,919.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,179.02 / $38,927.05
| Facility | | $7,117.00 | $18,179.02 | $38,927.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,076.96 / $34,592.61
| Facility | | $3,308.00 | $17,076.96 | $34,592.61 |