- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,198.40 / $11,956.00 / $19,408.30
| Facility | | $8,198.40 | $11,956.00 | $19,408.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,497.39 / $27,718.45 / $35,536.48
| Facility | | $19,497.39 | $27,718.45 | $35,536.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,626.85 / $18,612.61 / $23,541.58
| Facility | | $9,626.85 | $18,612.61 | $23,541.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,553.66 / $12,857.80 / $20,560.20
| Facility | | $8,553.66 | $12,857.80 | $20,560.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,003.41 / $17,105.96 / $25,988.93
| Facility | | $10,003.41 | $17,105.96 | $25,988.93 |