- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,201.84 / $21,040.00 / $33,877.10
| Facility | | $9,201.84 | $21,040.00 | $33,877.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.76 / $6,242.69 / $29,609.00
| Facility | | $1,258.76 | $6,242.69 | $29,609.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,230.28 / $21,998.71 / $31,163.81
| Facility | | $15,230.28 | $21,998.71 | $31,163.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,312.93 / $18,450.91 / $38,749.21
| Facility | | $13,312.93 | $18,450.91 | $38,749.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,499.46 / $18,450.91 / $39,249.54
| Facility | | $12,499.46 | $18,450.91 | $39,249.54 |