- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,442.29 / $29,512.09
| Facility | | $15,488.17 | $23,442.29 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,952.62 / $30,199.52
| Facility | | $12,589.25 | $19,952.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $22,908.68 / $34,673.69
| Facility | | $14,454.40 | $22,908.68 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $21,379.62 / $31,622.78
| Facility | | $12,589.25 | $21,379.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,454.40 / $23,988.33
| Facility | | $9,120.11 | $14,454.40 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $24,547.09 / $33,113.11
| Facility | | $10,000.00 | $24,547.09 | $33,113.11 |