- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,576.70 / $19,203.80 / $25,770.00
| Facility | | $11,576.70 | $19,203.80 | $25,770.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,559.34 / $14,057.10 / $31,253.39
| Facility | | $10,559.34 | $14,057.10 | $31,253.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,292.99 / $16,276.03 / $26,042.27
| Facility | | $9,292.99 | $16,276.03 | $26,042.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.04 / $15,462.00 / $35,460.55
| Facility | | $9,506.04 | $15,462.00 | $35,460.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,286.23 / $15,231.10 / $21,842.65
| Facility | | $11,286.23 | $15,231.10 | $21,842.65 |