- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,420.20 / $21,069.80 / $34,980.90
| Facility | | $16,420.20 | $21,069.80 | $34,980.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,480.18 / $20,636.00 / $34,877.90
| Facility | | $13,480.18 | $20,636.00 | $34,877.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,276.41 / $21,516.03 / $34,784.00
| Facility | | $17,276.41 | $21,516.03 | $34,784.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,290.00 / $22,561.94 / $36,167.74
| Facility | | $11,290.00 | $22,561.94 | $36,167.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,858.27 / $22,081.43 / $30,275.26
| Facility | | $10,858.27 | $22,081.43 | $30,275.26 |