- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,184.40 / $22,763.10 / $39,826.80
| Facility | | $17,184.40 | $22,763.10 | $39,826.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,186.52 / $18,432.61 / $28,790.73
| Facility | | $11,186.52 | $18,432.61 | $28,790.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $20,056.91 / $39,588.86
| Facility | | $5,939.30 | $20,056.91 | $39,588.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,307.00 / $21,839.28 / $35,558.33
| Facility | | $13,307.00 | $21,839.28 | $35,558.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $25,181.04 / $35,829.86
| Facility | | $3,496.00 | $25,181.04 | $35,829.86 |