- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,647.40 / $20,727.09 / $36,264.60
| Facility | | $15,647.40 | $20,727.09 | $36,264.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,326.20 / $19,607.99 / $34,683.41
| Facility | | $10,326.20 | $19,607.99 | $34,683.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $16,897.09 / $34,543.40
| Facility | | $5,939.30 | $16,897.09 | $34,543.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,134.00 / $19,885.95 / $32,377.95
| Facility | | $13,134.00 | $19,885.95 | $32,377.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $21,360.29 / $32,625.20
| Facility | | $3,496.00 | $21,360.29 | $32,625.20 |