- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,691.10 / $21,415.30 / $30,321.70
| Facility | | $11,691.10 | $21,415.30 | $30,321.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,631.98 / $20,433.43 / $32,468.93
| Facility | | $12,631.98 | $20,433.43 | $32,468.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,155.22 / $19,264.18 / $34,274.04
| Facility | | $12,155.22 | $19,264.18 | $34,274.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,779.77 / $40,529.11
| Facility | | $7,117.00 | $17,779.77 | $40,529.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,779.77 / $36,016.29
| Facility | | $3,308.00 | $17,779.77 | $36,016.29 |