- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,813.20 / $23,578.60 / $38,325.10
| Facility | | $13,813.20 | $23,578.60 | $38,325.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $11,231.00 / $19,655.86
| Facility | | $11,231.00 | $11,231.00 | $19,655.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,844.71 / $18,734.33 / $29,555.21
| Facility | | $11,844.71 | $18,734.33 | $29,555.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,096.42 / $18,161.24 / $34,066.83
| Facility | | $10,096.42 | $18,161.24 | $34,066.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,505.00 / $19,566.96 / $26,914.76
| Facility | | $6,505.00 | $19,566.96 | $26,914.76 |