- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,890.10 / $25,416.80 / $41,313.00
| Facility | | $14,890.10 | $25,416.80 | $41,313.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $11,231.00 / $22,218.82
| Facility | | $11,231.00 | $11,231.00 | $22,218.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,768.17 / $20,194.91 / $31,859.44
| Facility | | $12,768.17 | $20,194.91 | $31,859.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,478.81 / $20,731.50 / $40,359.39
| Facility | | $10,478.81 | $20,731.50 | $40,359.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.00 / $21,092.47 / $29,013.12
| Facility | | $6,553.00 | $21,092.47 | $29,013.12 |