- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,484.70 / $24,724.90 / $40,188.30
| Facility | | $14,484.70 | $24,724.90 | $40,188.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,687.00 / $15,762.00 / $28,594.98
| Facility | | $9,687.00 | $15,762.00 | $28,594.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,420.56 / $19,645.13 / $30,992.09
| Facility | | $12,420.56 | $19,645.13 | $30,992.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.84 / $19,607.88 / $37,045.23
| Facility | | $11,339.84 | $19,607.88 | $37,045.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.00 / $20,518.24 / $28,223.26
| Facility | | $6,553.00 | $20,518.24 | $28,223.26 |