- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,060.00 / $20,359.30 / $35,826.40
| Facility | | $12,060.00 | $20,359.30 | $35,826.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,458.07 / $12,586.36 / $20,474.55
| Facility | | $8,458.07 | $12,586.36 | $20,474.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,970.45 / $18,688.25 / $25,912.84
| Facility | | $10,970.45 | $18,688.25 | $25,912.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,138.80 / $38,138.80 / $44,759.12
| Facility | | $38,138.80 | $38,138.80 | $44,759.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,742.91 / $25,343.72
| Facility | | $1,787.00 | $17,742.91 | $25,343.72 |