- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,607.80 / $23,324.00 / $40,808.10
| Facility | | $17,607.80 | $23,324.00 | $40,808.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,267.89 / $11,267.89 / $24,824.07
| Facility | | $11,267.89 | $11,267.89 | $24,824.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,707.53 / $19,683.89 / $40,388.08
| Facility | | $5,707.53 | $19,683.89 | $40,388.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,307.00 / $22,377.39 / $36,434.48
| Facility | | $13,307.00 | $22,377.39 | $36,434.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $24,036.45 / $36,712.69
| Facility | | $3,496.00 | $24,036.45 | $36,712.69 |