- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,616.80 / $21,279.20 / $30,129.10
| Facility | | $11,616.80 | $21,279.20 | $30,129.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,751.75 / $22,303.08 / $35,870.87
| Facility | | $13,751.75 | $22,303.08 | $35,870.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,078.00 / $18,310.98 / $34,056.30
| Facility | | $12,078.00 | $18,310.98 | $34,056.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,060.27 / $40,271.64
| Facility | | $7,117.00 | $18,060.27 | $40,271.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,666.82 / $35,787.48
| Facility | | $3,308.00 | $17,666.82 | $35,787.48 |