- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,151.30 / $22,258.30 / $31,515.40
| Facility | | $12,151.30 | $22,258.30 | $31,515.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,148.35 / $21,242.33 / $33,560.58
| Facility | | $13,148.35 | $21,242.33 | $33,560.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,633.72 / $20,022.53 / $35,623.26
| Facility | | $12,633.72 | $20,022.53 | $35,623.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,891.24 / $42,124.57
| Facility | | $7,117.00 | $18,891.24 | $42,124.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,940.66 / $37,434.10
| Facility | | $3,308.00 | $16,940.66 | $37,434.10 |