- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,542.09 / $29,943.70 / $48,671.10
| Facility | | $17,542.09 | $29,943.70 | $48,671.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $20,616.61 / $30,106.89
| Facility | | $11,231.00 | $20,616.61 | $30,106.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,042.25 / $23,791.75 / $37,533.79
| Facility | | $15,042.25 | $23,791.75 | $37,533.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,744.79 / $17,825.14 / $37,854.17
| Facility | | $8,744.79 | $17,825.14 | $37,854.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,328.00 / $24,540.27 / $34,381.67
| Facility | | $6,328.00 | $24,540.27 | $34,381.67 |