- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,310.20 / $20,717.59 / $29,333.90
| Facility | | $11,310.20 | $20,717.59 | $29,333.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,769.64 / $20,510.70 / $32,871.50
| Facility | | $12,769.64 | $20,510.70 | $32,871.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,759.22 / $21,860.00 / $33,157.44
| Facility | | $11,759.22 | $21,860.00 | $33,157.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,583.59 / $39,208.73
| Facility | | $7,117.00 | $17,583.59 | $39,208.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,639.30 / $34,842.93
| Facility | | $3,308.00 | $16,639.30 | $34,842.93 |