- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,153.20 / $22,261.80 / $31,520.30
| Facility | | $12,153.20 | $22,261.80 | $31,520.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,890.10 / $22,527.45 / $36,231.73
| Facility | | $13,890.10 | $22,527.45 | $36,231.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,635.70 / $20,025.66 / $35,628.85
| Facility | | $12,635.70 | $20,025.66 | $35,628.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,894.20 / $42,131.18
| Facility | | $7,117.00 | $18,894.20 | $42,131.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,482.58 / $37,439.96
| Facility | | $3,308.00 | $18,482.58 | $37,439.96 |