- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,469.40 / $22,840.90 / $32,340.20
| Facility | | $12,469.40 | $22,840.90 | $32,340.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,326.97 / $19,984.45 / $31,631.14
| Facility | | $12,326.97 | $19,984.45 | $31,631.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,964.38 / $20,546.58 / $36,555.62
| Facility | | $12,964.38 | $20,546.58 | $36,555.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $20,187.20 / $43,227.09
| Facility | | $7,117.00 | $20,187.20 | $43,227.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $18,963.34 / $38,413.85
| Facility | | $3,308.00 | $18,963.34 | $38,413.85 |