- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,000.90 / $21,982.70 / $31,125.20
| Facility | | $12,000.90 | $21,982.70 | $31,125.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,066.47 / $21,324.81 / $34,822.06
| Facility | | $13,066.47 | $21,324.81 | $34,822.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,477.30 / $19,774.63 / $35,182.21
| Facility | | $12,477.30 | $19,774.63 | $35,182.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,182.91 / $41,603.01
| Facility | | $7,117.00 | $18,182.91 | $41,603.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,250.89 / $36,970.62
| Facility | | $3,308.00 | $18,250.89 | $36,970.62 |