- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,329.40 / $16,332.00 / $28,574.80
| Facility | | $12,329.40 | $16,332.00 | $28,574.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,477.02 / $12,930.66 / $17,396.91
| Facility | | $7,477.02 | $12,930.66 | $17,396.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $13,861.29 / $28,337.17
| Facility | | $5,939.30 | $13,861.29 | $28,337.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,312.00 / $16,587.63 / $25,512.30
| Facility | | $11,312.00 | $16,587.63 | $25,512.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,830.90 / $25,707.12
| Facility | | $3,496.00 | $16,830.90 | $25,707.12 |