- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,872.70 / $21,747.80 / $30,792.60
| Facility | | $11,872.70 | $21,747.80 | $30,792.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,268.27 / $20,268.27 / $28,633.61
| Facility | | $20,268.27 | $20,268.27 | $28,633.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,545.85 / $23,600.40 / $38,045.12
| Facility | | $14,545.85 | $23,600.40 | $38,045.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,343.98 / $19,563.34 / $34,806.28
| Facility | | $12,343.98 | $19,563.34 | $34,806.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,935.56 / $41,158.50
| Facility | | $7,117.00 | $18,935.56 | $41,158.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,055.88 / $36,575.58
| Facility | | $3,308.00 | $18,055.88 | $36,575.58 |