- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,852.70 / $20,009.40 / $35,210.69
| Facility | | $11,852.70 | $20,009.40 | $35,210.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,947.80 / $22,850.04 / $37,570.82
| Facility | | $15,947.80 | $22,850.04 | $37,570.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,781.92 / $18,397.87 / $25,467.52
| Facility | | $10,781.92 | $18,397.87 | $25,467.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,995.15 / $32,995.15 / $38,722.61
| Facility | | $32,995.15 | $32,995.15 | $38,722.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,438.00 / $24,908.18
| Facility | | $1,787.00 | $17,438.00 | $24,908.18 |