- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,387.70 / $20,859.50 / $29,534.80
| Facility | | $11,387.70 | $20,859.50 | $29,534.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,230.17 / $21,452.20 / $34,400.19
| Facility | | $13,230.17 | $21,452.20 | $34,400.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,839.74 / $18,764.18 / $33,384.48
| Facility | | $11,839.74 | $18,764.18 | $33,384.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,292.40 / $39,477.21
| Facility | | $7,117.00 | $18,292.40 | $39,477.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,520.00 / $18,751.53 / $39,477.21
| Facility | | $6,520.00 | $18,751.53 | $39,477.21 |