- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.69 / $16,014.00 / $25,784.50
| Facility | | $7,003.69 | $16,014.00 | $25,784.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $6,242.69 / $22,683.77
| Facility | | $1,474.01 | $6,242.69 | $22,683.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,592.04 / $16,743.61 / $23,719.34
| Facility | | $11,592.04 | $16,743.61 | $23,719.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,132.71 / $14,043.33 / $29,492.73
| Facility | | $10,132.71 | $14,043.33 | $29,492.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,513.57 / $14,043.33 / $29,873.53
| Facility | | $9,513.57 | $14,043.33 | $29,873.53 |