- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,704.30 / $21,447.00 / $37,740.50
| Facility | | $12,704.30 | $21,447.00 | $37,740.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,650.50 / $17,197.28 / $28,434.74
| Facility | | $11,650.50 | $17,197.28 | $28,434.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,556.56 / $19,591.02 / $27,297.27
| Facility | | $11,556.56 | $19,591.02 | $27,297.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,476.10 / $40,476.10 / $47,502.14
| Facility | | $40,476.10 | $40,476.10 | $47,502.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,690.86 / $26,697.75
| Facility | | $1,787.00 | $18,690.86 | $26,697.75 |