- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,887.80 / $21,045.60 / $36,821.80
| Facility | | $15,887.80 | $21,045.60 | $36,821.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,940.12 / $19,039.04 / $26,769.35
| Facility | | $12,940.12 | $19,039.04 | $26,769.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $16,012.18 / $34,440.10
| Facility | | $5,939.30 | $16,012.18 | $34,440.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,706.73 / $21,189.00 / $32,875.43
| Facility | | $13,706.73 | $21,189.00 | $32,875.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $21,688.48 / $37,254.83
| Facility | | $3,496.00 | $21,688.48 | $37,254.83 |