- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,396.80 / $29,695.70 / $48,267.90
| Facility | | $17,396.80 | $29,695.70 | $48,267.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,723.00 / $24,586.80 / $27,736.25
| Facility | | $15,723.00 | $24,586.80 | $27,736.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,917.66 / $23,594.69 / $37,222.90
| Facility | | $14,917.66 | $23,594.69 | $37,222.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,369.02 / $16,516.77 / $37,540.62
| Facility | | $7,369.02 | $16,516.77 | $37,540.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $24,643.34 / $33,897.42
| Facility | | $6,842.00 | $24,643.34 | $33,897.42 |