- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,307.30 / $18,845.00 / $24,777.00
| Facility | | $11,307.30 | $18,845.00 | $24,777.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,334.36 / $17,142.90 / $23,152.77
| Facility | | $11,334.36 | $17,142.90 | $23,152.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,441.45 / $16,112.26 / $21,956.85
| Facility | | $10,441.45 | $16,112.26 | $21,956.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,132.19 / $17,455.00 / $21,118.00
| Facility | | $11,132.19 | $17,455.00 | $21,118.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,307.62 / $26,858.83
| Facility | | $5,274.00 | $17,307.62 | $26,858.83 |