- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.30 / $20,768.40 / $36,546.40
| Facility | | $12,302.30 | $20,768.40 | $36,546.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,797.30 / $18,735.80 / $30,768.11
| Facility | | $12,797.30 | $18,735.80 | $30,768.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,190.90 / $19,027.82 / $26,433.57
| Facility | | $11,190.90 | $19,027.82 | $26,433.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,371.05 / $39,371.05 / $46,205.27
| Facility | | $39,371.05 | $39,371.05 | $46,205.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,963.00 / $25,853.02
| Facility | | $1,787.00 | $18,963.00 | $25,853.02 |