- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,452.09 / $31,975.80 / $51,974.10
| Facility | | $19,452.09 | $31,975.80 | $51,974.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,473.15 / $22,430.09 / $26,145.77
| Facility | | $11,473.15 | $22,430.09 | $26,145.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,905.05 / $28,704.88 / $41,237.76
| Facility | | $15,905.05 | $28,704.88 | $41,237.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,347.09 / $23,942.73 / $45,995.13
| Facility | | $13,347.09 | $23,942.73 | $45,995.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,000.00 / $26,813.00 / $36,826.94
| Facility | | $16,000.00 | $26,813.00 | $36,826.94 |