- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,148.40 / $20,421.09 / $28,914.10
| Facility | | $11,148.40 | $20,421.09 | $28,914.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,172.95 / $17,868.62 / $28,110.45
| Facility | | $11,172.95 | $17,868.62 | $28,110.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,590.92 / $18,369.84 / $32,682.88
| Facility | | $11,590.92 | $18,369.84 | $32,682.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,662.93 / $38,647.57
| Facility | | $7,117.00 | $17,662.93 | $38,647.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,954.34 / $34,344.25
| Facility | | $3,308.00 | $16,954.34 | $34,344.25 |