- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,778.30 / $19,743.20 / $27,954.20
| Facility | | $10,778.30 | $19,743.20 | $27,954.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,858.25 / $19,368.86 / $31,462.96
| Facility | | $11,858.25 | $19,368.86 | $31,462.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,206.14 / $17,760.03 / $31,597.92
| Facility | | $11,206.14 | $17,760.03 | $31,597.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $16,597.28 / $37,364.60
| Facility | | $7,117.00 | $16,597.28 | $37,364.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,391.53 / $33,204.12
| Facility | | $3,308.00 | $16,391.53 | $33,204.12 |