- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,190.50 / $19,101.70 / $31,048.30
| Facility | | $11,190.50 | $19,101.70 | $31,048.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $17,856.27 / $22,699.20
| Facility | | $11,231.00 | $17,856.27 | $22,699.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,595.76 / $15,177.24 / $23,943.56
| Facility | | $9,595.76 | $15,177.24 | $23,943.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,703.30 / $13,002.80 / $24,147.94
| Facility | | $6,703.30 | $13,002.80 | $24,147.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $16,073.58 / $21,804.45
| Facility | | $6,289.00 | $16,073.58 | $21,804.45 |