- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,139.09 / $18,364.40 / $38,427.60
| Facility | | $18,139.09 | $18,364.40 | $38,427.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,933.07 / $29,929.98 / $40,511.65
| Facility | | $14,933.07 | $29,929.98 | $40,511.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,840.68 / $24,272.03 / $33,870.55
| Facility | | $12,840.68 | $24,272.03 | $33,870.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.00 / $20,725.30 / $37,806.55
| Facility | | $820.00 | $20,725.30 | $37,806.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.00 / $18,382.43 / $38,974.37
| Facility | | $820.00 | $18,382.43 | $38,974.37 |