- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,230.10 / $22,402.50 / $31,719.50
| Facility | | $12,230.10 | $22,402.50 | $31,719.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,054.53 / $17,548.06 / $27,741.95
| Facility | | $11,054.53 | $17,548.06 | $27,741.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,522.90 / $20,152.24 / $35,854.03
| Facility | | $12,522.90 | $20,152.24 | $35,854.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,537.06 / $42,397.45
| Facility | | $7,117.00 | $18,537.06 | $42,397.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,599.40 / $37,676.58
| Facility | | $3,308.00 | $18,599.40 | $37,676.58 |