- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,011.20 / $17,235.09 / $30,154.90
| Facility | | $13,011.20 | $17,235.09 | $30,154.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,877.24 / $9,877.24 / $14,169.55
| Facility | | $9,877.24 | $9,877.24 | $14,169.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $15,288.87 / $30,177.56
| Facility | | $5,939.30 | $15,288.87 | $30,177.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,937.52 / $17,405.89 / $26,923.05
| Facility | | $11,937.52 | $17,405.89 | $26,923.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,761.59 / $27,128.64
| Facility | | $3,496.00 | $17,761.59 | $27,128.64 |