- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,436.70 / $16,701.00 / $21,950.90
| Facility | | $11,436.70 | $16,701.00 | $21,950.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,975.68 / $13,550.66 / $22,919.11
| Facility | | $4,975.68 | $13,550.66 | $22,919.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,029.00 / $15,977.40 / $28,077.96
| Facility | | $8,029.00 | $15,977.40 | $28,077.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,385.84 / $18,721.39 / $27,334.75
| Facility | | $14,385.84 | $18,721.39 | $27,334.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,385.84 / $17,404.03 / $27,334.75
| Facility | | $14,385.84 | $17,404.03 | $27,334.75 |