- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,878.30 / $18,383.80 / $32,164.70
| Facility | | $13,878.30 | $18,383.80 | $32,164.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,971.86 / $15,038.80 / $23,635.39
| Facility | | $9,971.86 | $15,038.80 | $23,635.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $15,925.39 / $31,814.07
| Facility | | $5,939.30 | $15,925.39 | $31,814.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,649.00 / $17,640.04 / $28,717.43
| Facility | | $12,649.00 | $17,640.04 | $28,717.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $18,945.38 / $28,936.72
| Facility | | $3,496.00 | $18,945.38 | $28,936.72 |