- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,241.60 / $12,019.00 / $19,510.59
| Facility | | $8,241.60 | $12,019.00 | $19,510.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,475.03 / $16,390.21 / $31,449.55
| Facility | | $13,475.03 | $16,390.21 | $31,449.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,974.16 / $24,131.30 / $30,937.57
| Facility | | $16,974.16 | $24,131.30 | $30,937.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,677.58 / $18,710.68 / $23,665.63
| Facility | | $9,677.58 | $18,710.68 | $23,665.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,598.74 / $12,925.60 / $20,668.59
| Facility | | $8,598.74 | $12,925.60 | $20,668.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.12 / $17,196.09 / $26,125.87
| Facility | | $10,056.12 | $17,196.09 | $26,125.87 |