- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,109.30 / $27,626.10 / $33,486.00
| Facility | | $11,109.30 | $27,626.10 | $33,486.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,942.00 / $11,201.90 / $18,687.66
| Facility | | $3,942.00 | $11,201.90 | $18,687.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,059.82 / $14,291.92 / $23,432.06
| Facility | | $10,059.82 | $14,291.92 | $23,432.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,992.07 / $17,092.63 / $23,601.85
| Facility | | $9,992.07 | $17,092.63 | $23,601.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,160.55 / $23,083.49
| Facility | | $1,787.00 | $16,160.55 | $23,083.49 |