- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,195.40 / $16,154.50 / $28,264.30
| Facility | | $12,195.40 | $16,154.50 | $28,264.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,096.23 / $14,918.00 / $20,039.78
| Facility | | $9,096.23 | $14,918.00 | $20,039.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,901.77 / $29,658.34
| Facility | | $5,939.30 | $14,901.77 | $29,658.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,189.09 / $16,407.40 / $25,235.10
| Facility | | $11,189.09 | $16,407.40 | $25,235.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,648.03 / $25,427.80
| Facility | | $3,496.00 | $16,648.03 | $25,427.80 |