- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,394.70 / $20,872.30 / $29,552.90
| Facility | | $11,394.70 | $20,872.30 | $29,552.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,508.00 / $18,511.00 / $29,406.16
| Facility | | $11,508.00 | $18,511.00 | $29,406.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,847.00 / $18,775.70 / $33,404.94
| Facility | | $11,847.00 | $18,775.70 | $33,404.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,714.86 / $39,501.42
| Facility | | $7,117.00 | $17,714.86 | $39,501.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,328.93 / $35,103.01
| Facility | | $3,308.00 | $17,328.93 | $35,103.01 |