- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,197.00 / $20,590.59 / $36,233.50
| Facility | | $12,197.00 | $20,590.59 | $36,233.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,804.88 / $15,818.81 / $25,977.81
| Facility | | $10,804.88 | $15,818.81 | $25,977.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,095.12 / $18,880.29 / $26,207.32
| Facility | | $11,095.12 | $18,880.29 | $26,207.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,134.44 / $37,134.44 / $43,580.43
| Facility | | $37,134.44 | $37,134.44 | $43,580.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,944.55 / $25,631.74
| Facility | | $1,787.00 | $17,944.55 | $25,631.74 |