- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,407.40 / $20,895.50 / $29,585.80
| Facility | | $11,407.40 | $20,895.50 | $29,585.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,289.10 / $19,767.08 / $31,587.61
| Facility | | $12,289.10 | $19,767.08 | $31,587.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,860.20 / $18,796.62 / $33,442.17
| Facility | | $11,860.20 | $18,796.62 | $33,442.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,757.12 / $39,545.43
| Facility | | $7,117.00 | $18,757.12 | $39,545.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,903.45 / $35,142.12
| Facility | | $3,308.00 | $15,903.45 | $35,142.12 |