- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,118.00 / $17,695.80 / $23,258.40
| Facility | | $12,118.00 | $17,695.80 | $23,258.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,246.84 / $22,459.25 / $37,986.79
| Facility | | $8,246.84 | $22,459.25 | $37,986.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $17,917.54 / $29,750.44
| Facility | | $12,882.50 | $17,917.54 | $29,750.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,242.74 / $19,836.54 / $28,962.96
| Facility | | $15,242.74 | $19,836.54 | $28,962.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,107.21 / $17,347.41 / $27,040.69
| Facility | | $10,107.21 | $17,347.41 | $27,040.69 |