- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,451.20 / $19,482.09 / $29,699.40
| Facility | | $11,451.20 | $19,482.09 | $29,699.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,930.80 / $22,407.76 / $35,807.40
| Facility | | $13,930.80 | $22,407.76 | $35,807.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,905.74 / $18,868.79 / $33,570.58
| Facility | | $11,905.74 | $18,868.79 | $33,570.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,856.06 / $39,697.26
| Facility | | $7,117.00 | $18,856.06 | $39,697.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,802.68 / $35,277.07
| Facility | | $3,308.00 | $17,802.68 | $35,277.07 |