- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,709.80 / $19,768.09 / $34,786.19
| Facility | | $11,709.80 | $19,768.09 | $34,786.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,797.78 / $16,903.87 / $27,793.93
| Facility | | $11,797.78 | $16,903.87 | $27,793.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,651.92 / $18,197.65 / $25,160.47
| Facility | | $10,651.92 | $18,197.65 | $25,160.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,787.10 / $39,787.10 / $46,693.54
| Facility | | $39,787.10 | $39,787.10 | $46,693.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,878.86 / $24,607.87
| Facility | | $1,787.00 | $16,878.86 | $24,607.87 |