- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,871.80 / $23,578.10 / $33,384.10
| Facility | | $12,871.80 | $23,578.10 | $33,384.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,224.61 / $21,335.30 / $33,694.79
| Facility | | $13,224.61 | $21,335.30 | $33,694.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,382.82 / $21,209.74 / $37,735.50
| Facility | | $13,382.82 | $21,209.74 | $37,735.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $19,345.84 / $44,622.30
| Facility | | $7,117.00 | $19,345.84 | $44,622.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $19,575.41 / $39,653.69
| Facility | | $3,308.00 | $19,575.41 | $39,653.69 |