- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,449.90 / $20,973.40 / $29,696.10
| Facility | | $11,449.90 | $20,973.40 | $29,696.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,692.80 / $20,118.16 / $31,934.31
| Facility | | $12,692.80 | $20,118.16 | $31,934.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,904.42 / $18,866.70 / $33,566.86
| Facility | | $11,904.42 | $18,866.70 | $33,566.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,800.72 / $39,692.87
| Facility | | $7,117.00 | $17,800.72 | $39,692.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,412.91 / $35,273.16
| Facility | | $3,308.00 | $17,412.91 | $35,273.16 |