- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,597.80 / $24,232.00 / $39,016.60
| Facility | | $10,597.80 | $24,232.00 | $39,016.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,017.87 / $20,792.14
| Facility | | $1,474.01 | $6,017.87 | $20,792.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,335.09 / $23,998.28 / $35,891.65
| Facility | | $16,335.09 | $23,998.28 | $35,891.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,332.63 / $21,250.10 / $38,311.42
| Facility | | $15,332.63 | $21,250.10 | $38,311.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,540.25 / $20,663.79 / $38,311.42
| Facility | | $13,540.25 | $20,663.79 | $38,311.42 |