- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,526.20 / $24,795.70 / $40,303.50
| Facility | | $14,526.20 | $24,795.70 | $40,303.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,710.00 / $20,354.66 / $24,176.27
| Facility | | $7,710.00 | $20,354.66 | $24,176.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,456.16 / $19,701.43 / $31,080.91
| Facility | | $12,456.16 | $19,701.43 | $31,080.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,941.71 / $13,041.85 / $31,346.22
| Facility | | $4,941.71 | $13,041.85 | $31,346.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.00 / $20,577.05 / $28,304.15
| Facility | | $6,553.00 | $20,577.05 | $28,304.15 |